title: Histological analysis of gallbladder diseases in relation to opisthorchiasis in endemic areas of Thailand.
abstract: Chronic gallbladder disease frequently accompanies infection with the liver fluke, Opisthorchis viverrini, in Northeast Thailand. However, the pathology and pathogenesis of the gallbladder disease have not been described. Accordingly, gallbladder specimens from 187 consecutive patients who had undergone cholecystectomy at a referral hospital in an endemic area in Thailand were histologically characterized in relation to O. viverrini infection. The infection was assessed by the presence of parasite eggs in the bile and/or antibody response to the liver fluke. The average level of parasite-specific IgG was significantly higher in patients with Opisthorchis eggs in the bile than those without (P<0.001). The main histopathologic features of the gallbladder included inflammation, mucosal atrophy/or hyperplasia, goblet cell metaplasia, mucous gland hyperplasia, Rokitansky-Aschoff sinus formation, dysplasia and fibrosis. The fibrosis was strongly associated with elevated levels of Opisthorchis-specific antibody (P<0.001) but not with the presence of parasite eggs. Other pathologic features did not vary in frequency or severity with parasitological status. Our results show that severe fibrosis of the gallbladder is a more common histologic feature of cholecystitis among those with O. viverrini infection compared to those without infection. The close relationship between parasite-specific IgG and severe fibrosis suggests that specific immune response to the parasite play an important role in the pathogenesis of the fibrotic change.
authors: Division of Experimental Pathology, Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. banchob@kku.ac.th
authors: Banchob
authors: B
authors: Sripa
authors: Melissa R
authors: MR
authors: Haswell-Elkins
authors: Poonsiri
authors: P
authors: Sinawat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D002764:Cholecystitis / Q000150:complications* / Q000469:parasitology / Q000473:pathology; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009889:Opisthorchiasis / Q000150:complications* / Q000469:parasitology / Q000473:pathology; D009891:Opisthorchis / Q000254:growth & development*; D010270:Parasite Egg Count; D013785:Thailand
chemical_list: D000909:Antibodies, Helminth