Have you returned from Thailand with a parasite? Diagnosis may now be easier.

An international study with the participation of the National Center for Microbiology (CNM) of the Carlos III Health Institute (ISCIII) has achieved advances that could facilitate the rapid diagnosis of a parasite that affects the liver, causing an infection - opisthorchiasis - linked to an increased risk of developing cholangiocarcinoma , a type of bile duct cancer .

' Opisthorchis viverrini ' is a liver fluke of great importance , mainly in regions of Southeast Asia , especially in countries such as Thailand , Laos and Cambodia , and can infect humans through the consumption of raw or undercooked fish .

Opisthorchiasis, linked to high mortality rates if not diagnosed early , is recognized by the World Health Organization (WHO) as a group 1 biological carcinogen , due to its strong association with cholangiocarcinoma , a cancer that affects the pathways that carry bile from the liver to the small intestine.

The aim of the study, published in the journal Nature Communications , was to develop rapid, point-of-care (PoC) diagnostic tests for O. viverrini infection and associated cholangiocarcinoma . These tools allow for diagnoses to be made at the point of patient care. The research is being led by an international team of Thai, American, and Australian researchers , and includes Javier Sotillo of CNM-ISCIII .

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The work reveals the development of a pioneering proteomic microarray— a chip capable of analyzing diverse biological material , such as genes—based on the parasite's secretome (a set of proteins that function outside the cells ). This tool has made it possible to evaluate the response of different antibodies in sera from people infected with O. viverrini in Thailand and Laos, and in patients with cholangiocarcinoma linked to the infection .

The CNM-ISCIII researcher has participated in the collection, analysis, and interpretation of the information derived from the development of the microarray. Thanks to this proteomic analysis , nine candidate antigens have been identified for diagnostic improvement, including a cathepsin C protease and an NADP-dependent IDH enzyme. Both candidates were produced in the laboratory and applied in rapid immunochromatographic tests to detect infection-specific antibodies , demonstrating better sensitivity and specificity —over 80%—than conventional diagnostic methods .

These two biomarkers , the authors explain, could form the basis for developing new serodiagnostic tests for the infection and associated cancer. "These rapid and standardizable diagnostic tools could transform the surveillance of this liver fluke in endemic areas of Southeast Asia, allowing for the detection of both active infections and cases of cholangiocarcinoma at early stages , which would represent a crucial innovation for improving the management, control, and prevention of this highly fatal disease ," Javier Sotillo concludes.

An international study with the participation of the National Center for Microbiology (CNM) of the Carlos III Health Institute (ISCIII) has achieved advances that could facilitate the rapid diagnosis of a parasite that affects the liver, causing an infection - opisthorchiasis - linked to an increased risk of developing cholangiocarcinoma , a type of bile duct cancer .