Hepatoalveolar echinococcosis is a chronic zoonotic parasitic disease caused by the larvae of the tapeworm Echinococcus multilocularis. Because its biological characteristics are similar to liver malignant tumors and have a certain degree of invasiveness, radical surgical treatment is difficult. Currently, the mainstream treatment plan for hepatoalveolar echinococcosis is surgical resection, supplemented by oral antiparasitic drugs, but the postoperative recurrence rate is still high. With the continuous development of targeted and immunotherapy, the development of new targeted drugs for hepatic alveolar echinococcosis has also become a trend. This article will review the current treatment status of hepatic alveolar echinococcosis and its potential therapeutic targets, and provide a new theoretical basis for the development of new targeted drugs.

Fei Ke, Linxun Liu, Qihua Feng, Mengzhao Xu, Runwu Cao. New Directions for Target Therapy of Hepato-alveolar Echinococcosis. International Journal of Frontiers in Medicine (2024), Vol. 6, Issue 7: 72-78. https://doi.org/10.25236/IJFM.2024.060712.

[1] Sichuan province echinococcosis clinical medical research center, Sichuan province physician association echinococcosis professional committee. Expert consensus on diagnosis and treatment of alveolar hepatic echinococcosis (2020 edition) [J]. Chinese Journal of Bases and Clinics in General Surgery, 2020, 27(1):13-17. 

[2] Yang Lingpeng, Qiu Yiwen, Yang Xianwei, et al. Preliminary study of reasonable and feasible safe distance for radical resection of hepatic alveolar echinococcosis [J]. Chinese Journal of Bases and Clinics in General Surgery, 2022, 29(04):512-516. 

[3] Tian Qingshan, Feng Shaopei, Guo Yamin, et al. Postoperative complications of ex vivo liver resection combined with autologous liver transplantation in treatment of advanced hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies [J]. Journal of Clinical Hepatology, 2021, 37(9): 2153-2160. 

[4] Wen Hao, Luan Meixiang, Wang Xiyan, et al. The first report of liver transplantation for hepatic alveolar echinococcosis in China [J]. Bulletin of Disease Control & Prevention (China), 2001, 16(3): 100. 

[5] Wang H, Liu Q, Wang Z, et al. Clinical outcomes of Ex Vivo liver resection and liver autotransplantation for hepatic alveolar echinococcosis[J]. Journal of Huazhong University of Science and Technology Medical Sciences, 2012, 32(4):598-600. 

[6] Qu Bo, Guo Long, Sheng Guannan, et al. Management of Advanced Hepatic Alveolar Echinococcosis: Report of 42 Cases.[J]. The American journal of tropical medicine and hygiene, 2017, 96(3):680-685. 

[7] Feng Shaopei, Guo Yamin, Han Xiumin. The Status and Progress of Minimally Invasive Surgical Treatment on Hepatic Alveolar Echinococcosis [J]. Parasitoses and Infectious Diseases, 2021, 19(01):51-56. 

[8] Tang Junke, Zhang Ying, Qu Yanling, etal. Treatment of late alveolar echinococcosis [J]. Parasitoses and Infectious Diseases, 2015, 13(03):123-126. 

[9] Gottstein B, Soboslay P, Ortona E, et al. Immunology of Alveolar and Cystic Echinococcosis (AE and CE).[J]. Advances in parasitology, 2017, 96:1-54. 

[10] Dong Yinan, Sun Qian, Zhang Xinwei, et al. PD-1 and its ligands are important immune checkpoints in cancer.[J]. Oncotarget, 2017, 8(2):2171-2186.  

[11] Parvez Adil, Choudhary Furqan, Mudgal Priyal, et al. PD-1 and PD-L1: architects of immune symphony and immunotherapy breakthroughs in cancer treatment [J]. Frontiers in Immunology, 2023, 14:1296341. 

[12] Singh Vishakha, Khurana Amit, Allawadhi Prince, et al. Emerging Role of PD-1/PD-L1 Inhibitors in Chronic Liver Diseases[J]. Frontiers in Pharmacology, 2021, 12:790963. 

[13] Li Yanhua, Wang Jing, Hu Xiaoan, et al. Changes of serum soluble PD-1 / PD-L1 and related cytokines levels in patients with echinococcosis [J]. Chinese Journal of Cellular and Molecular, 2014, 30(4):421-423. 

[14] Li Yanhua, Zhang Fengbo, Zhao Hui, et al. The dynamic change of negative costimulatory molecules PD-1 and CTLA-4 inEchinococcus multilocularis infection [J]. Immunological Journal, 2013, 29(12):1018-1023. 

[15] Yuxuan Yang, Tana Wuren, Binjie Wu, et al. The expression of CTLA-4 in hepatic alveolar echinococcosis patients and blocking CTLA-4 to reverse T cell exhaustion in Echinococcus multilocularis-infected mice[J]. Frontiers in Immunology, 2024, 15:1358361. 

[16] Liu Lu, You Xuewu, Han Sai, et al. CD155/TIGIT, a novel immune checkpoint in human cancers (Review)[J]. Oncology Reports, 2021, 45(3):835-845. 

[17] Zhang Chuanshan, Lin Renyong, Li Zhide, et al. Immune exhaustion of T cells in alveolar echinococcosis patients and its reversal by blocking checkpoint receptor TIGIT in a murine model.[J]. Hepatology (Baltimore, Md.), 2019, 71(4):1297-1315. 

[18] Chuanshan Zhang, Wang Hui, Jing Li, et al. Involvement of TIGIT in NK Cell Exhaustion and Immune Escape in Patients and Mouse Model with Liver E. multilocularis Infection.[J]. Hepatology (Baltimore, Md.), 2021, 74(6):3376-3393. 

[19] Zhang Shijie, Wu Hexing, Li Qi, et al. Expressions of MVD-CD34 and VEGF in Hepatic Alveolar Hydatid Tissue in Gerbil Model and Their Clinical Signii cances [J]. Chinese Journal of Bases and Clinics In General Surgery, 2015, 22(02):134-138. 

[20] Jiang Huijiao, Gui Xianwei, Guo Lijiao, et al. Expression and angiogenic effect of VEGFA/VEGFR2 in mice hepatic metacestode tissue of Echinococcus multilocularis [J]. Chinese Journal of Parasitology and Parasitic Diseases, 2020, 38(06):673-681. 

[21] Sang Zejie, Zhu Diwen, Ji Weizheng, et al. Dynamic observation on the serum level of vascular endothelial growth factor in experimental rats with hepatic alveolar echinococcosis after hepatic arterial infusion of bevacizumab treatment [J]. Journal of Interventional Radiology, 2014, 23(06):516-519. 

[22] Hu Chunhui, Zhang Fabin, Fan Haining, et al. Improvement of the Bioavailability and Anti-Hepatic Alveolar Echinococcosis by Albendazole-Isethionate/Hypromellose Acetate Succinate (HPMC-AS) Complex [J]. Antimicrobial agents and chemotherapy, 2021, 65(7):e0223320. 

[23] Wang W, Li J, Yao J, et al. In vitro and in vivo efficacies of novel carbazole aminoalcohols in the treatment of cystic echinococcosis[J]. Journal of Antimicrobial Chemotherapy, 72(11):3122-3130. 

[24] Dang Zhisheng, Xu Shuo, Zhang Haobing, et al. In vitro and in vivo efficacies of carbazole aminoalcohols in the treatment of alveolar echinococcosis[J]. Acta Tropica, 2018, 185:138-143. 

[25] Cai Xiaoli, Wang Weisi, Lai Dehua, et al. Identification of an orally active carbazole aminoalcohol derivative with broad-spectrum anti-animal trypanosomiasis activity[J]. Acta Tropica, 2021, 219:105919. 

[26] Abulaihaiti Maitiseyiti, Wu Xiang-Wei, Qiao Lei, et al. Efficacy of Albendazole-Chitosan Microsphere-based Treatment for Alveolar Echinococcosis in Mice.[J]. PLoS neglected tropical diseases, 2015, 9(9):e0003950. 

[27] Li J, Yang Y, Han X, et al. Oral Delivery of Anti-Parasitic Agent-Loaded PLGA Nanoparticles: Enhanced Liver Targeting and Improved Therapeutic Effect on Hepatic Alveolar Echinococcosis[J]. International Journal of Nanomedicine, 2023, 18:3069-3085.