Adult Clonorchis sinensis live in the bile duct and cause clonorchiasis. It is known that the C. sinensis metacercariae excyst in the duodenum and migrate up to the bile duct through the common bile duct. However, no direct evidence is available on the in vivo migration of newly excysted C. sinensis juveniles (CsNEJs). Advanced imaging technologies now allow the in vivo migration and localization to be visualized. In the present study, we sought to determine how sensitively CsNEJs respond to bile and how fast they migrate to the intrahepatic bile duct using PET-CT.
CsNEJs were radiolabeled with 18F-fluorodeoxyglucose (18F-FDG). Rabbits with a gallbladder contraction response to cholecystokinin-8 (CCK-8) injection were pre-screened using cholescintigraphy. In these rabbits, gallbladders contracted by 50% in volume at an average of 11.5 min post-injection. The four rabbits examined were kept anesthetized and a catheter inserted into the mid duodenum. Gallbladder contraction was stimulated by injecting CCK-8 (20 ng/kg every minute) over the experiment. Anatomical images were acquired by CT initially and dynamic PET was then carried out for 90 min with a 3-min acquisition per frame. Twelve minutes after CCK-8 injection, about 3,000 18F-FDG-labeled CsNEJs were inoculated into the mid duodenum through the catheter. Photon signals were detected in the liver 7–9 min after CsNEJs inoculation, and these then increased in the whole liver with stronger intensity in the central area, presenting that the CsNEJs were arriving at the intrahepatic bile ducts.
In the duodenum, CsNEJs immediately sense bile and migrate quickly with bile-chemotaxis to reach the intrahepatic bile ducts by way of the ampulla of Vater.
Clonorchis sinensis adults habituating in the bile duct cause clonorchiasis endemic in East Asian countries, in which about 15–20 million people are supposedly infected. It has previously been reported that C. sinensis metacercariae excyst in the duodenum and that the juvenile flukes migrate to the bile duct through the ampulla of Vater in 4–7 hours. Recently advanced imaging technologies have enabled visualization of movements and localizations of parasites in mammalian hosts. From present study, we found the following: newly excysted C. sinensis juveniles (CsNEJs) were efficiently in vitro radiolabeled with 18F-FDG since CsNEJs have glucose transporters; CCK-8-induced gallbladder contraction was various rabbit to rabbit; CsNEJs promptly recognized bile and migrated up the duodenum to reach the intrahepatic bile ducts by way of the ampulla of Vater and the common bile duct as early as 7–9 minutes after inoculation. Some CsNEJs responding slowly to the bile delayed arriving at the distal bile capillaries. It was visualized for the first time that the CsNEJs migrate quickly within 10–20 minutes from the duodenum to the intrahepatic bile duct. These findings provide fundamental information on the migration of parasites living in the biliary passages of mammals.