Trends in Parasitology
ReviewClinical and Preclinical Imaging of Hepatosplenic Schistosomiasis
Section snippets
HSS
Schistosomiasis, a waterborne helminthic disease, is a major cause of chronic morbidity and premature death in Africa, South America, Southeast Asia, and the Middle East, whereas imported cases have recently been on the rise in Europe. Schistosoma mansoni and Schistosoma japonicum are the main causative agents of HSS. Schistosome eggs eliminated with mammalian excreta hatch in water and release miracidia that infect specific intermediate host snails. The gastropods shed cercariae that can
Overview of Imaging Modalities and Applications to HSS
Imaging allows the assessment of HSS morbidity by diagnosing and staging fibrosis, evaluating vascular complications, guiding surgical interventions, and monitoring response to treatment. Improving fibrosis diagnosis and staging, especially early and mild forms, with noninvasive and quantitative methods is a major challenge in liver imaging, regardless of the cause of fibrosis. Preclinical imaging studies are essential to better characterize specific morphological and functional changes linked
Elastography
Elastography has become the most widely used method for detecting liver fibrosis and cirrhosis consecutive to steatosis or viral hepatitis [37]. Elastography cannot be regarded as an emerging method, but so far only a few studies have reported its use in HSS.
In sonographic elastography, tissue excitation is either induced by acoustic radiation force impulse (ARFI) or by using a mechanical vibrating device for transient elastography (TE). Pulse–echo acquisitions are performed to measure the
Animal Models
Models of schistosomiasis have been developed in different animal species, providing the opportunity to study the host's immune response to schistosome infection, granulomatous inflammation, and fibrogenesis, and to evaluate new therapies or vaccine candidates. Although they do not recapitulate all the features of the human disease, they remain clinically relevant as they develop liver fibrosis [81] and PH [82]. The characterization of experimental HSS with imaging methods is essential for the
Concluding Remarks
Assessment of HSS morbidity and treatment monitoring would benefit from noninvasive imaging methods, allowing reliable fibrosis staging and estimation of vascular dysfunction (see Outstanding Questions). Quantitative methods, which have been successfully evaluated on human fibrotic and cirrhotic liver (USG elastography, MRE, 31P-MRS, ASL, perfusion PET etc.), or in experimental schistosomiasis (T2 mapping), have a potential for clinical/human schistosomiasis assessment provided that the
Acknowledgements
This work was funded by CNRS (Centre National pour la Recherche Scientifique) and Aix-Marseille University. The Center for Magnetic Resonance in Biology and Medicine (CRMBM) is a member of France Life Imaging (grant ANR-11-INBS-0006 from the French 'Investissements d’Avenir' program).
Glossary
- Arterial spin labeling (ASL)
- a quantitative microvascular perfusion MRI technique relying on magnetically labeled arterial blood water molecules as endogenous tracer.
- Bioluminescence imaging (BLI)
- a whole-animal imaging method requiring the introduction of a bioluminescent reporter gene (e.g., firefly luciferase gene) fused to a gene of interest. When the luciferase substrate is injected into the animal, its oxidation results in detectable light emission.
- Contrast agents (CAs)
- mostly intravenously
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