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Clonorchiasis: an update

Published online by Cambridge University Press:  12 April 2024

H.-J. Rim*
Affiliation:
Department of Parasitology, College of Medicine, Korea University, Seoul, 136-705, Korea
*
*Fax: +(822) 780 6251 Email: hjrim@korea.ac.kr

Abstract

Clonorchis sinensis, the Chinese or oriental liver fluke, is an important human parasite and is widely distributed in southern Korea, China (including Taiwan), Japan, northern Vietnam and the far eastern part of Russia. Clonorchiasis occurs in all parts of the world where there are Asian immigrants from endemic areas. The human and animal reservoir hosts (dogs, pigs, cats and rats) acquire the infection from the ingestion of raw fish containing infectious metacercariae. The first intermediate snail hosts are mainly species of Parafossarulus and Bithynia. Numerous species of freshwater fish serve as the second intermediate hosts of C. sinensis. Extensive studies of clonorchiasis during several decades in Japan, Korea, China and other countries have shown much progress in proving its morphological features including ultrastructure, biology, pathogenesis, epidemiology, clinical manifestations and chemotherapy. The present review deals with mainly current results obtained on the epidemiological, pathological and clinical aspects, as well as control measures in endemic areas. As for the complications of clonorchiasis, formation of calculi in the intrahepatic biliary passages is one of the most characteristic pathological features. It is sometimes accompanied by suppurative cholangitis, cholecystitis, cholangiohepatitis and ultimately can cause cholangiocarcinoma. Experimental results on the relationship to the occurrence of cholangiocarcinoma are presented. Clinical diagnosis by radiological findings including cholangiography, sonography and computerized tomography as well as magnetic resonance imaging for biliary or pancreatic ducts are outlined. Current studies on immunology and molecular biology of C. sinensis were introduced. Praziquantel is the drug of choice for clonorchiasis. The most effective regimen is 25 mg kg−1 three times daily (total dose, 75 mg kg−1) administered orally at 5- to 6-h intervals over a single day. Prevention and control measures are also discussed.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2005

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References

Belamaric, J. (1973) Intrahepatic bile duct carcinoma and C. sinensis infection in Hong Kong. Cancer 31, 468473.3.0.CO;2-J>CrossRefGoogle Scholar
Chen, C.Y., Shin, J.W., Chen, S.N. & Hsieh, W.C. (1989) A preliminary study of clinical staging in clonorchiasis. Chinese Journal of Microbiology and Immunology (Taiwan) 22, 193200.Google ScholarPubMed
Chen, E.R. (1991) Current status of food-borne parasitic zoonoses in Taiwan. Southeast Asian Journal of Tropical Medicine and Public Health . 22 (Supplement), 6264.Google ScholarPubMed
Chen, M., Lu, Y., Hua, X. & Mott, K.E. (1994) Progress in assessment of morbidity due to Clonorchis sinensis infection: a review of recent literature. Tropical Diseases Bulletin 91, R7R65.Google Scholar
Chen, X.B., Hu, S.F. & Shen, J.L. (1988) Detection of antibody levels in treated patients with clonorchiasis. Acta Academiae Medicinae Bengbu 13, 215217 (in Chinese).Google Scholar
Choi, B.I., Park, J.H., Kim, Y.I., Yu, E.S., Kim, S.H., Kim, W.H., Kim, C.Y. & Han, M.C. (1988) Peripheral cholangiocarcinoma and clonorchiasis: CT findings. Radiology 169, 149153.CrossRefGoogle ScholarPubMed
Choi, B.I., Kim, H.J., Han, M.C., Do, Y.S., Han, M.H. & Lee, S.H. (1989) CT findings of clonorchiasis. American Journal of Roentgenology 152, 281284.CrossRefGoogle ScholarPubMed
Choi, B.I., Kim, T.K. & Han, J.K. (1998) MRI of clonorchiasis and cholangiocarcinoma. Journal of Magnetic Resonance Imaging 8, 359366.CrossRefGoogle ScholarPubMed
Choi, D., Hong, S.T., Lim, J.H., Cho, S.Y., Rim, H.J., Ji, Z., Yuan, R. & Wang, S. (2004) Sonographic findings of active Clonorchis sinensis infection. Journal of Clinical Ultrasound 32, 1723.CrossRefGoogle ScholarPubMed
Chou, S.T. & Chan, C.W. (1976) Mucin-producing cholangiocarcinoma: an autopsy study in Hong Kong. Parasitology 8, 321328.Google ScholarPubMed
Chou, S.T. & Gibson, J.B. (1970) The histochemistry of biliary mucins and the changes caused by infection with Clonorchis sinensis. Journal of Pathology 101, 185201.Google Scholar
Chung, Y.B., Yang, H.J., Hong, S.J., Kang, S.Y., Lee, M., Kim, T.Y., Choi, M.H., Chai, J.Y. & Hong, S.T. (2003) Molecular cloning and immunolocalization of the 17 kDa myoglobin of Clonorchis sinensis. Parasitology Research 90, 365368.CrossRefGoogle ScholarPubMed
Cross, J.H. (1984) Changing pattern of some trematode infections in Asia. Arzneimittel Forschung 34, 12241226.Google ScholarPubMed
Fang, Y.Y. (1994) Epidemiologic characteristics of clonorchiasis sinensis in Guangdong Province. China. Southeast Asian Journal of Tropical Medicine and Public Health 25, 291295.Google Scholar
Figurnov, V.A., Chertov, A.D., Romanenko, N.A., Grigorenko, A.A., Gavrilov, V.A., Soldatkin, P.K., Prokhorov, P.P., Solozhenkin, V.G., Kalinina, V.V., Katin, I.S., Gavrilov, A.V., Mosolova, N.P. & Figurnova, E.V. (2002) Clonorchiasis in the Upper Amur region: biology, epidemiology, clinical presentation. Medical Parasitology (Moskva) Oct-Dec, 2023 (in Ruian).Google ScholarPubMed
Gibson, J.B. & Sun, T. (1971) Clonorchiasis. pp.546566 Marcial-Rojas, R.A. (Eds) Pathology of protozoal and helminthic diseases with clinical correlation . Baltimore, Williams & Wilkins.Google Scholar
Hong, S.J., Seong, K.Y., Sohn, W.M. & Song, K.Y. (2000) Molecular cloning and immunological characterization of phosphoglycerate kinase from Clonorchis sinensis. Molecular and Biochemical Parasitology 108, 207216.CrossRefGoogle ScholarPubMed
Hong, S.J., Lee, J.Y., Lee, D.H., Sohn, W.M. & Cho, S.Y. (2001) Molecular cloning and characterization of a mu -class glutathione S-transferase from Clonorchis sinensis. Molecular and Biochemical Parasitology 115, 6975.CrossRefGoogle Scholar
Hong, S.J., Kim, T.Y., Gan, X.X., Shen, L.Y., Sukontason, K. & Kang, S.Y. (2002a) Clonorchis sinensis : glutathione S-transferase as a serodiagnostic antigen for detection IgG and IgE antibodies. Experimental Parasitology 101, 231233.CrossRefGoogle ScholarPubMed
Hong, S.J., Kim, T.Y., Kang, S.Y., Yu, J.R., Song, K.Y. & Cho, S.Y. (2002b) Clonorchis sinensis : immunolocalization of 26 kDa glutathione S-transferase in adult worms. Experimental Parasitology 102, 191193.CrossRefGoogle ScholarPubMed
Hong, S.J., Yu, J.R. & Kang, S.Y. (2002c) Ultrastructural localization of 28 kDa glutathione S-transferase in adult Clonorchis sinensis. Korean Journal of Parasitology 40, 173176.CrossRefGoogle ScholarPubMed
Hong, S.J., Shin, J.K., Kang, S.Y. & Ryu, J.R. (2003) Ultrastructural localization of phosphoglycerate kinase in adult Clonorchis sinensis. Parasitology Research 90, 369371.CrossRefGoogle ScholarPubMed
Hong, S.T. (1988) Changes of anti- Clonorchis sinensis IgG antibody in serum after praziquantel treatment in human clonorchiasis. Korean Journal of Parasitology 26, 18.CrossRefGoogle ScholarPubMed
Hou, M.F., Ker, C.G., Sheen, P.C. & Chen, E.R. (1989) The ultrasound survey of gallstone diseases of patients infected with Clonorchis sinensis in southern Taiwan. Journal of Tropical Medicine and Hygiene 92, 108111.Google ScholarPubMed
Hou, P.C. (1956) Relationship between primary carcinoma of the liver and infestation with Clonorchis sinensis. Journal of Pathology and Bacteriology 72, 239246.Google ScholarPubMed
Hwang, S.Y., Han, H.J., Kim, S.H., Park, S.G., Seog, D.H., Kim, N., Han, J., Chung, J.Y. & Kho, W.G. (2003) Cloning of a pore-forming subunit of ATP-sensitive potassium channel from Clonorchis sinensis. Korean Journal of Parasitology 41, 129133.CrossRefGoogle ScholarPubMed
IARC (1994) Schistosomes, liver flukes and Helicobacter pylori. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 61, 270pp. International Agency for Research on Cancer, WHO.Google Scholar
Ji, Z., Li, Z., Wang, S., Yuan, R., Zhen, S., Feng, Z., Xu, L., Hong, S.T., Cho, S.Y., Choi, D.I., Hong, K.S. & Rim, H.J. (2004) Final report of China–Korea collaborative project of control strategies of clonorchiasis in Heilongjiang pilot areas (2001–2004). pp. 3356 in Proceedings of the 5th workshop on the Korea–China collaborative project of control strategies for helminthiasis in pilot areas , November.Google Scholar
Joo, K.H. & Rim, H.J. (1982) Observation on the serum IgE level and eosinophil counts in clonorchiasis. Korea University Medical Journal 19, 5162. (in Korean)Google Scholar
Kammerer, W.S., Decker, J.D., Keith, T.B. & Mott, K.E. (1977) Clonorchiasis in New York City Chinese. Tropical Doctor 7, 105106.CrossRefGoogle ScholarPubMed
Kang, S.Y., Ahn, I.Y., Park, C.Y., Chung, Y.B., Hong, S.T., Kong, Y., Cho, S.Y. & Hong, S.J. (2001) Clonorchis sinensis : molecular cloning and characterization of 28-kDa glutathione S-transferase. Experimental Parasitology 97, 186195.CrossRefGoogle ScholarPubMed
Kim, D.C. (1974) Ecological studies of Clonorchis sinensis. Yonsei Reports of Tropical Medicine 5, 344.Google Scholar
Kim, H.D., Eom, K.S. & Rim, H.J. (1987) Changes of serum and urine antibody levels by ELISA after treatment in clonorchiasis. Korea University Medical Journal 24, 107116 (in Korean).Google Scholar
Kim, M.S., Lee, J.S. & Rim, H.J. (1982a) Studies on the clinical aspects of clonorchiasis in Korea. Korea University Medical Journal 19, 107121 (in Korean).Google Scholar
Kim, S.S., Kim, S.J. & Rim, H.J. (1982b) Electron-microscopic studies on the effect of praziquantel to Clonorchis sinensis. Korea University Medical Journal 19, 91105 (in Korean).Google Scholar
Kim, T.Y., Kang, S.Y., Ahn, I.Y., Cho, S.Y. & Hong, S.J. (2001) Molecular cloning and characterization of antigenic protein with a repeating region from Clonorchis sinensis. Korean Journal of Parasitology 39, 5766.CrossRefGoogle ScholarPubMed
Kim, Y.I. (1984) Liver carcinoma and liver fluke infection. Arzneimittel Forschung 34, 11211126.Google ScholarPubMed
Kim, Y.I., Yang, D.H. & Chang, K.L. (1974) Relationship between Clonorchis sinensis infection and cholangiocarcinoma of the liver in Korea. Seoul Journal of Medicine 15, 247255.(in Korean).Google Scholar
Kim, Y.I., Yu, E.S. & Kim, S.T. (1989) Intraductal variant of peripheral cholangiocarcinoma of the liver with Clonorchis sinensis infection. Cancer 63, 15621566.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
Komiya, Y. (1966) Clonorchis and clonorchiasis. Advances in Parasitology 4, 53106.CrossRefGoogle ScholarPubMed
Komiya, Y. & Suzuki, N. (1964) The distribution of Clonorchis infection in Japan with remarks on its epidemiology. Progress of Medical Parasitology in Japan 1, 3133.Google Scholar
Lee, J.H. & Rim, H.J. (1996) Cholangiocarcinoma caused by Clonorchis sinensis infection in laboratory animals. pp. 4349 in Proceedings of the 2nd Japan–Korea Parasitologists Seminar (Forum Cheju-2) , April.Google Scholar
Lee, J.H., Rim, H.J. & Bak, U.B. (1993) Effect of Clonorchis sinensis and dimethylnitrosamine administration on the induction of cholangiocarcinoma in Syrian golden hamsters. Korean Journal of Parasitology 31, 2130.CrossRefGoogle ScholarPubMed
Lee, J.H., Yang, H.M., Bak, U.B. & Rim, H.J. (1994) Promoting role of Clonorchis sinensis infection on induction of cholangiocarcinoma during two-step carcinogenesis. Korean Journal of Parasitology 32, 1318.CrossRefGoogle ScholarPubMed
Lee, J.H., Rim, H.J. & Sell, S. (1995) Promotion of cholangiocarcinomas by Clonorchis sinensis infection in hamsters after induction by dimethylnitrosamine. Journal of Tumor Marker Oncology 10, 716.Google Scholar
Lee, J.H., Rim, H.J. & Sell, S. (1997) Heterogeneity of the ‘oval-cell’ response in the hamster liver during cholangiocarcinogenesis following Clonorchis sinensis infection and dimethylnitrosamine treatment. Journal of Hepatology 26, 13131323.CrossRefGoogle ScholarPubMed
Lee, J.S. & Yong, T.S. (2004) Expression and cross-species reactivity of fatty acid-binding protein of Clonorchis sinensis. Parasitology Research 93, 339343.CrossRefGoogle ScholarPubMed
Lee, J.S., Lee, J., Park, S.J. & Yong, T.S. (2003a) Analysis of the genes expressed in Clonorchis sinensis adults using the expressed sequence tag approach. Parasitological Research 91, 283289.CrossRefGoogle ScholarPubMed
Lee, J.Y., Cho, P.Y., Kim, T.Y., Kang, S.Y., Song, K.Y. & Hong, S.J. (2002) Hemolytic activity and developmental expression of pore-forming peptide, clonorin. Biochemistry and Biophysical Research Communications 296, 12381244.CrossRefGoogle ScholarPubMed
Lee, J.Y., Kim, T.Y., Gan, X.X., Kang, S.Y. & Hong, S.J. (2003b) Use of a recombinant Clonorchis sinensis pore-forming peptide, clonorin, for serological diagnosis of clonorchiasis. Parasitology International 52, 175178.CrossRefGoogle ScholarPubMed
Lee, K.H., Eom, K.S. & Rim, H.J. (1986) Serum IgG levels of clonorchiasis patients before and after therapy with praziquantel. Korea University Medical Journal 23, 1322(in Korean).Google Scholar
Lee, M.K., Kim, S.J. & Rim, H.J. (1983) Electron-microscopic studies on the effect of various drugs to Clonorchis sinensis. Korea University Medical Journal 20, 145164.(in Korean).Google Scholar
Lee, S.H. (1984) Large scale treatment of Clonorchis sinensis infections with praziquantel under field conditions. Arzneimittel Forschung 34, 12271230.Google ScholarPubMed
Lee, S.H., Hwang, S.W., Chai, J.Y. & Seo, B.S. (1984) Comparative morphology of eggs of heterophyids and Clonorchis sinensis causing human infections in Korea. Korean Journal of Parasitology 22, 171180.CrossRefGoogle ScholarPubMed
Leung, J.W., Sung, J.Y., Chung, S.C. & Metreweli, C. (1989) Hepatic clonorchiasis–a study by endoscopic retrograde cholangiopancreatography. Gastrointestinal Endoscopy 35, 226231.CrossRefGoogle ScholarPubMed
Li, S., Chung, Y.B., Chung, B.S., Choi, M.H., Yu, J.R. & Hong, S.T. (2004) The involvement of the cysteine proteinases of Clonorchis sinensis metacercariae in excystment. Parasitology Research 93, 3640.CrossRefGoogle ScholarPubMed
Li, Y.J., Li, S.L. & Bao, Z.Y. (1990) Two different dosage-schedules of praziquantel in the treatment of Clonorchis sinensis infection. Guangxi Medicine 12, 6566(in Chinese).Google Scholar
Lim, J.H. (1990) Radiologic findings of clonorchiasis. American Journal of Roentgenology 155, 10011008.CrossRefGoogle ScholarPubMed
Lim, J.H. & Ko, Y.T. (1990) Clonorchiasis of pancreas. Clinical Radiology 41, 195198.CrossRefGoogle Scholar
Lim, J.H., Ko, Y.T., Lee, D.H. & Kim, S.Y. (1989) Clonorchiasis: sonographic findings in 59 proved cases. American Journal of Roentgenology 152, 761764.CrossRefGoogle ScholarPubMed
Liu, H.R., Wang, H., Liu, K. & Liu, F.K. (1989) Determination of serum immunoglobulins in Clonorchis sinensis -infected subjects. Journal of Beijing Medical University 21 185 (in Chinese).Google Scholar
Mehlhorn, H., Kojima, S., Rim, H.J., Ruenwongsa, P., Andrews, P., Thomas, H. & Bunnag, B. (1983) Ultrastructural investigations on the effects of praziquantel on human trematodes from Asia: Clonorchis sinensis, Metagonimus yokogawai, Opisthorchis viverrini, Paragonimus westermani and Schistosoma japonicum. Arzneimittel Forschung 33, 9198.Google ScholarPubMed
MHSA & KAPE (1982) Report on the pilot treatment project of Clonorchis sinensis infection with praziquantel, 145(in Korean).Google Scholar
MHSA & KAH (1992) Evaluation of the mass-treatment project of clonorchiasis in Korea. (1984–1990), 1118(in Korean).Google Scholar
Min, D.Y. (1984) Remarks on the diagnosis of Clonorchis sinensis infection. Arzneimittel Forschung 34, 11531156.Google ScholarPubMed
Na, B.K., Lee, H.J., Cho, S.H., Lee, H.W., Cho, J.H., Kho, W.G., Lee, J.S., Lee, J.S., Song, K.J., Park, P.H., Song, C.Y. & Kim, T.S. (2002) Expression of cysteine proteinase of Clonorchis sinensis and its use in serodiagnosis of clonorchiasis. Journal of Parasitology 88, 10001006.CrossRefGoogle ScholarPubMed
Nagano, I., Pei, F., Wu, Z., Wu, J., Cui, H., Boonmars, T. & Takahashi, Y. (2004) Molecular expression of a cysteine proteinase of Clonorchis sinensis and its application to an enzyme-linked immunosorbent assay for immunodiagnosis. Clinical and Diagnostic Laboratory Immunology 11, 411416.Google Scholar
Nontasut, P., Thong, T.V., Waikagul, J., Fungladda, W., Imamee, N. & De, N.V. (2003) Social and behavioral factors associated with Clonorchis infection in one commune located in the Red River Delta of Vietnam. Southeast Asian Journal of Tropical Medicine and Public Health 34, 269273.Google ScholarPubMed
Ohshima, H. & Bartsch, H. (1994) Chronic infections and inflammatory processes as cancer risk factors: possible role of nitric oxide in carcinogenesis. Mutation Research 305, 253264.CrossRefGoogle ScholarPubMed
Park, G.M. & Yong, T.S. (2001) Geographical variation of the liver fluke, Clonorchis sinensis , from Korea and China based on the karyotypes, zymodeme and DNA sequences. Southeast Asian Journal of Tropical Medicine and Public Health 32, Suppl 2, 1216.Google ScholarPubMed
Park, G.M., Im, K.I., Huh, S. & Yong, T.S. (2000) Chromosomes of the liver fluke, Clonorchis sinensis. Korean Journal of Parasitology 38, 201206.CrossRefGoogle ScholarPubMed
Park, S.B., Joo, K.H. & Rim, H.J. (1984) Studies on the epidemiological changes of clonorchiasis in the high endemic area (Kimhae City). Korea University Medical Journal 21, 7790(in Korean).Google Scholar
Park, S.Y., Lee, K.H., Hwang, Y.B., Kim, K.Y., Park, S.K., Hwang, H.A., Sakanari, J.A., Hong, K.M., Kim, S. & Park, H. (2001) Characterization and large-scale expression of the recombinant cysteine proteinase from adult Clonorchis sinensis. Journal of Parasitology 87, 14541458.CrossRefGoogle ScholarPubMed
Parkin, D.M., Oshima, H., Srivatanakul, P. & Vatanasapt, V. (1993) Cholangiocarcinoma: epidemiology, mechanisms of carcinogenesis and prevention. Cancer Epidemiology, Biomarkers and Prevention 2, 537544.Google ScholarPubMed
Purtilo, D.T. (1976) Clonorchiasis and hepatic neoplasm. Tropical and Geographical Medicine 28, 2127.Google Scholar
Qu, Z.Q., Chen, R.X., Zeng, M.A., Li, J.Y., Zhang, C.D., Zeng, L.T., Qu, B.D. & Han, B.Y. (1983) Alteration of antibody levels in patients with Clonorchis sinensis after chemotherapy. National Medical Journal of China 63, 241243(in Chinese).Google Scholar
Quan, F.S., Matsumoto, T., Shin, Y.O., Min, Y.K., Yan, H.M., Othman, T. & Lee, J.B. (2004) Relationships between IgG, IgM, IgE and resistance to reinfection during the early phase of infection with Clonorchis sinensis in rats. Immunological Investigations 33, 5160.CrossRefGoogle ScholarPubMed
Rim, H.J. (1984) Studies on clonorchiasis in Korea. Journal of Natural Academic Science Korea, Natural Science Series 23, 279354.Google Scholar
Rim, H.J. (1986) The current pathobiology and chemotherapy of clonorchiasis. Korean Journal of Parasitology 24 Supplement 1141.CrossRefGoogle ScholarPubMed
Rim, H.J. (1997) Epidemiology and control of clonorchiasis in Korea. Southeast Asian Journal of Tropical Medicine and Public Health 28 Supplement 1 4750>.Google ScholarPubMed
Rim, H.J. (2003) Experiences on the epidemiology and control of clonorchiasis in Korea and China. pp. 1115 in Proceedings of the 4th Workshop Report on the Korea–China Collaborative Project of Control Strategies for Helminthiasis in Pilot Areas .Google Scholar
Rim, H.J., Lyu, K.S., Lee, J.S. & Joo, K.H. (1981) Clinical evaluation of the therapeutic efficacy of praziquantel against Clonorchis sinensis infection in man. Annals of Tropical Medicine and Parasitology 75, 2733.CrossRefGoogle ScholarPubMed
Shu, J., Wen, J.S. & Li, Y.H. (1992) A case of intracranial hypertension induced by treatment with praziquantel for clonorchiasis in a patient complicated with cerebral cysticercosis. Chinese Journal ofParasitology and Parasitic Diseases 10 289(in Chinese).Google Scholar
Sim, S., Park, G.M. & Yong, T.S. (2003) Cloning and characterization of Clonorchis sinensis myoglobin using immune sera against excretory secretory antigens. Parasitology Research 91, 338343.CrossRefGoogle ScholarPubMed
Song, L., Chen, S.., Yu, X., Wu, Z., Xu, J., Yang, G., Zheng, N., Hu, X., Guo, L., Dai, J., Xu, J., Ji, C., Gu, S. & Ying, K. (2004) Molecular cloning and characterization of cDNA encoding a ubiquitin-conjugating enzyme from Clonorchis sinensis. Parasitology Research 94, 227232.CrossRefGoogle ScholarPubMed
Su, Z.C. & Mon, R.K. (1983) A grand mal of epilepsy after treatment with praziquantel in a patient with Clonorchis sinensis . Chinese Journal of Parasitology and Parasitic Diseases 1 192(in Chinese).Google Scholar
Wang, J., Lu, Z.Y., Wang, W., Wang, M.J., Chen, M.G. & Qiu, L.S. (1985) Changes in antibody levels in clonorchiasis patients before and after treatment. Chinese Journal of Parasitology and Parasitic Diseases 3 60(in Chinese).Google Scholar
WHO (1995) Control of foodborne trematode infections. WHO Technical Report Series 849, 1157.Google Scholar
Yang, H.J., Park, S.J., Im, K. & Yong, T.S. (2000) Identification of a Clonorchis sinensis gene encoding a vitellaria antigenic protein containing repetitive sequences. Molecular and Biochemical Parasitology 111, 213216.CrossRefGoogle ScholarPubMed
Yen, C.M., Chen, E.R., Hou, M.F. & Chang, J.H. (1992) Antibodies of different immunoglobulin isotypes in serum and bile of patients with clonorchiasis. Annals of Tropical Medicine and Parasitology 86, 263269.CrossRefGoogle ScholarPubMed
Yong, T.S., Im, K. & Chung, P.R. (1991) Diagnosis of clonorchiasis by ELISA-inhibition test using Clonorchis sinensis specific monoclonal antibodies. Southeast Asian Journal of Tropical Medicine and Public Health 22 Supplement 186188.Google Scholar
Yong, T.S., Lee, J.S., Cho, S.N., Seo, J.H. & Park, H. (1996) A carbohydrate antigen of Clonorchis sinensis recognized by a species-specific monoclonal antibody. Korean Journal of Parasitology 34, 279281.CrossRefGoogle ScholarPubMed
Yong, T.S., Yang, H.J., Park, S.J., Kim, Y.K., Lee, D.H. & Lee, S.M. (1998) Immunodiagnosis of clonorchiasis using a recombinant antigen. Korean Journal of Parasitology 36, 183190.CrossRefGoogle ScholarPubMed
Yu, S., Xu, L., Jiang, Z., Xu, S., Han, J., Zhu, Y., Chang, J., Lin, J. & Xu, F. (1994) Report on the first nationwide survey of the distribution of human parasites in China. 1. Regional distribution of parasite species. Chinese Journal of Parasitology and Parasitic Disease 12, 241247(in Chinese).Google Scholar
Zhou, Z.R. & Zhao, M.L. (1981) Measurment of IgE by RIST (radioimmunosorbent test) and IgE antibody against Clonorchis sinensis antigens by RAST (radioallergensorbent test). Journal of China Medical University 10, 2427(in Chinese).Google Scholar