The research deals with cholangiocarcinoma (CCA), bile duct cancer, caused by infection with the liver fluke, Opisthorchis viverrini. CCA is a primary cancer originating in the epithelium (cholangiocytes) ofthe bile ducts. It has long latency, is invasive, metastasizes and has a dismal prognosis. The mechanisms by which chronic infection with the flukes results in CCA are likely multi-factorial, but one mechanism is the secretion of parasite proteins with mitogenic and anti-apoptotic properties, both features of a pre-cancerous cellular environment. We have characterised the excretory/secretory (ES) products of O. viverrini and identified two candidate ES proteins that are central to these processes - we showed that a homologue of the human secreted growth factor, granulin, binds to cholangiocytes and stimulates proliferation of fibroblasts and CCA cell lines. We also showed that secreted thioredoxin peroxidase blocks apoptosis of damaged cholangiocytes. Progression of chronic opisthorchiasis to CCA follows a multi-factorial route(s). We hypothesize that key processes along the route include (1) secretion of parasite proteins which induce pathology in the biliary tract and establish an environment conducive to cancer development by promoting cell proliferation and DNA damage, accelerating wound healing and blocking apoptosis;and (2) repeated administration of the anthelmintic drug praziquantel, for treatment of O. viverrini (Ov) infection, causes increased inflammation in the bile ducts and thereby precipitates tumorigenesis. The research will investigate these phenomena by assessing the ability of Ov-ES to (1) facilitate wound repair in mammalian cells;(2) promote cell invasion and migration;(3) interfere with apoptosis. To further address the carcinogenic roles of these proteins, we will vaccinate hamsters with Ov-ES and its defined components to determine whether this intervention can protect against liver fluke infection and CCA, and assessment of impact of repeated PZQ therapy in accelerating tumorigenesis.

Public Health Relevance

Despite treatment and health education campaigns, the prevalence of O. viverrini infection remains high in Northeast Thailand;more problematically, infection with O. viverrini often leads to a deadly form of liver cancer. The work proposed here investigates - at the molecular level - how liver fluke infection causes this liver cancer, and could offer new strategies to control this disease.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
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Khon Kaen University
Khon Kaen
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Sripa, Banchob; Tangkawattana, Sirikachorn; Sangnikul, Thinnakorn (2016) The Lawa model: A sustainable, integrated opisthorchiasis control program using the EcoHealth approach in the Lawa Lake region of Thailand. Parasitol Int :
Teimoori, Salma; Arimatsu, Yuji; Laha, Thewarach et al. (2016) Chicken IgY-based coproantigen capture ELISA for diagnosis of human opisthorchiasis. Parasitol Int :
Sereerak, Piya; Upontain, Songkaid; Tangkawattana, Prasarn et al. (2016) Efficacious and safe dose of praziquantel for the successful treatment of feline reservoir hosts with opisthorchiasis. Parasitol Int :
Sripa, Banchob; Deenonpoe, Raksawan; Brindley, Paul J (2016) Co-infections with liver fluke and Helicobacter species: A paradigm change in pathogenesis of opisthorchiasis and cholangiocarcinoma? Parasitol Int :
Van, Chinh Dang; Doungchawee, Galayanee; Suttiprapa, Sutas et al. (2016) Association between Opisthorchis viverrini and Leptospira spp. infection in endemic Northeast Thailand. Parasitol Int :
Echaubard, Pierre; Sripa, Banchob; Mallory, Frank F et al. (2016) The role of evolutionary biology in research and control of liver flukes in Southeast Asia. Infect Genet Evol 43:381-97
Saltykova, Irina V; Ogorodova, Ludmilla M; Ivanov, Vladimir V et al. (2016) Carbonyl stress phenomena during chronic infection with Opisthorchis felineus. Parasitol Int :
Chaiyadet, Sujittra; Smout, Michael; Laha, Thewarach et al. (2016) Proteomic characterization of the internalization of Opisthorchis viverrini excretory/secretory products in human cells. Parasitol Int :
Vinh, Hoang Quang; Phimpraphai, Waraphon; Tangkawattana, Sirikachorn et al. (2016) Risk factors for Clonorchis sinensis infection transmission in humans in northern Vietnam: A descriptive and social network analysis study. Parasitol Int 66:74-82
Laohaviroj, Marut; Chamgramol, Yaovalux; Pairojkul, Chawalit et al. (2016) Clinicopathological Significance of Osteopontin in Cholangiocarcinoma Cases. Asian Pac J Cancer Prev 17:201-5

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