Primary pelvic Echinococcus granulosus infection:A case report

BACKGROUND Primary pelvic Echinococcus granulosus infection is clinically rare.The reported cases of pelvic Echinococcus granulosus infection are considered to be secondary to cystic echinococcosis in other organs.Single Echinococcus granulosus infection is very rare.CASE SUMMARY In this report,we presented a case of primary pelvic Echinococcus granulosus infection admitted to the First Affiliated Hospital of Xinjiang Medical University.We described the key diagnostic points and surgical treatment of this case.We also summarized the epidemiological characteristics and pathogenesis of the disease.CONCLUSION Our case may provide clinical data for the diagnosis and treatment of primary pelvic Echinococcus granulosus infection.

Echinococcus Granulosus 14-3-3 Protein:A Potential Vaccine Candidate Against Challenge with Echinococcus Granulosus in Mice

Objective To investigate the protective immunity against Echinococcus granulosus in mice immunized with rEg14-3-3. Methods ICR mice were subcutaneously immunized three times with rEg14-3-3, followed by the challenge with Echinococcus granulosus protoscoleces intraperitoneally and then sacrificed after six months of post-challenge to detect the proliferation of splenocytes by MTT assay, and to measure the secretion of IL-2, IL-4, IL-20, and IFN -y by ELISA. The rate of reduced hydatid cyst and the levels of IgE, igG and IgG subclasses in sera were examined. Results Mice vaccinated with rEg14-3-3 and challenged with protoscoleces revealed significant protective immunity of 84.47%. ELISA analysis indicated that the immunized mice generated specific high levels of IgG and the prevailing isotypes of IgG were IgG1 and IgG2a. Splenocytes from mice immunized with rEg14-3-3 showed a significant proliferation response. The secretion of IFN-V and IL-2 increased significantly in the vaccinated mice whereas there was no significant difference in IL-4 and IL-20 levels between vaccinated and control mice. Conclusion The results indicate that the rEg24-3-3 vaccine could induce a high level of protective immunity as a promising vaccine candidate to prevent cystic echinococcosis.

Analysis of Protoscoleces-specific Antigens from Echinococcus Granulosus with Proteomics Combined with Western Blot

Objective To establish and optimize the proteomic analysis of protoscoleces-specific antigens from Echinococcus granulosus. To provide a foundation for identifying specific antigens in the soluble proteins of E. granulosus protoscoleces for further research. Methods Brood capsules were collected aseptically from fertile E. granulosus cysts from the livers of an infected patient. The fertile E. granulosus cysts were fractured, and protoscoleces were collected by centrifugation. The soluble proteins of protoscoleces were acquired using the 2D Quant kit according to the manufacturer＇s instructions. We employed two-dimensional electrophoresis （2-DE） combined with immunoblot assay （Western blot） to analyze the soluble components of E. granulosus protoscoleces antigens. The 2-DE and immunoblot maps obtained were analyzed with PDQuest 8.0 image analysis software. Results About 233 soluble protein spots were identified with Coomassie-stained gels. Most of the proteins had a molecular weight of 16 000 Da to 117 000 Da, and an isoelectric point value of 3.0 to 10.0. 2-DE immunoblot was conducted and 57 specific antigen spots were observed, among which 23 spots were identified. Conclusion 2-DE combined with Western blot is the key to successful proteomic analysis and presents a new possibility for searching the specific E. granulosus protoscoleces antigens.

Genetic diversity and phylogenetic analysis of EG95 sequences of Echinococcus granulosus:Implications for EG95 vaccine application

Objective:To analyse the genetic variability of EG95 sequences and provide guidance for EG95 vaccine application against Echinococcus granulosus(E. granulosus). Methods:We analysed EG95 polymorphism by collecting total 97 different E. granulosus isolates from 12 different host species that originated from 10 different countries. Multiple sequence alignments and the homology were performed by Lasergene 1(DNASTAR Inc.,Madison,WI),and the phylogenetic analysis was performed by using MEGA5.1(CEMI,Tempe,AZ,USA). In addition,linear and conformational epitopes were analysed,including secondary structure,NXT/S glycosylation,fibronectin type ecoⅢ(Fnndary Ⅲ) domain and glycosylphosphatidylinositol anchor signal(GPIanchor). The s structure was predicted by PSIPRED method. Results:Our results indicated that most isolates overall shared 72.6-100% identity in EG95 gene sequence with the published standard EG95 sequence,X90928. However,EG95 gene indeed has polymorphism in different isolates. Phylogenetic analysis showed that different isolates could be divided into three subgroups. Subgroup 1 contained 87 isolates while Subgroup 2 and Subgroup 3 consisted of 3 and 7 isolates,respectively. Four sequences cloned from oncosphere shared a high identity with the parental sequence of the current vaccine,X90928,and they belonged to Subgroup 1. However,in comparison to X90928,several amino acid mutations occurred in most isolates besides oncosphere,which potentially altered the immunodominant linear epitopes,glycosylation sites and secondary structures in EG95 genes. All these variations might change their previous antigenicity and thereby affecting the efficacy of current EG95 vaccine. Conclusions:This study reveals the genetic variability of EG95 sequences in different E. granulosus isolates,and proposed that more vaccination trials would be needed to test the effectiveness of current EG95 vaccine against distinct isolates in different countries.

Echinococcus Granulosus: Suitable in vitro Protoscolices Culture Density

The present study is to determine the suitable protoscolices （PSCs） density for long-time culturing in vitro. The PSCs were divided into eight groups with different densities and the viability tests were carried out with 0.1% methylene blue staining. Then the infection ability of cultured PSCs was assessed by the mean cyst weight of mice inoculated intraperitoneally with PSCs after 8 months post-infection.

Study of Infection of Echinococcus granulosus in Yak in Spring and Its Potential Role in Transmission of Cystic Echinococcosis in Rangtang County of Sichuan,China

Dear Editor, Cystic echinococcosis （CE）, caused by Echinococcus granulosus in larval stage, is considered as one of the most dangerous parasitic zoonosis in the world. The obligate 2-host parasitic cycle of Echinococcus granulosus is predominantly synanthropic. Dogs are the usual definitive hosts, and lots of mammalian species can be intermediate hosts, including domestic livestock and human[I2]. In the Tibetan plateau, China, the population is mainly Tibetans primarily engaged in livestock husbandry and CE is therefore a health problem for both people and animal in Tibetan communities. The reported infection rate of Echinococcus gronulosus in slaughtered yak in slaughterhouses is usually very high, being about 50% or higher as reported, and the liver and lungs are the main affected organs[34].

A multiplex PCR for differential detection of Echinococcus granulosus sensu stricto,Echinococcus multilocularis and Echinococcus canadensis in China

Background:Echinococcosis caused byEchinococcus is one of the most major infectious diseases in north-west highland of China.E.granulosus sensu strict,E.multilocularis,andE.canadensis are known to be the only three species related to human health transmitting in the areas.To achieve targeted treatment and control of echinococcosis,the accurate identification and discrimination of the species are important.However,currently the available diagnostic approaches do not present ideal results either in accuracy or efficiency.Methods:In the study,a set of primers were designed to aim at the three human-pathogenicEchinococcus species in China.The one-step multiplex PCR assay was developed and evaluated for the specificity and sensitivity.A total of 73parasitic lesions and 41 fecal materials obtained from human and various animals collected in the clinic and the field were tested to assess the applicability of this method.Results:The multiplex PCR effectively detected the individual DNA from the targeted species and their random mixtures generating with distinguishable expected size of products.The detection limit of the assay for each of the three species was 5 pg/μl when they were tested separately.When DNA mixtures of the targeted species containing the same concentration were used as templates,the lowest amount of DNA which can be detected was 50 pg/μl,10 pg/μl and 5 pg/μl forE.granulosus s.s.,E.multilocularis,andE.canadensis respectively.No cross-reactivity was observed when DNA from eight genetically close species was used as control templates.The multiplex PCR identifications of all samples were in line with the original sequencing results except for those infected withE.shiquicus,which showed negative signals in the developed assay.Of all the tested stool materials,16 were previously found positive forEchinococcus by visual and microscopic examination.Among these 16 samples,13 were confirmed by the multiplex PCR,and the other three tested negative.Additionally,the multiplex PCR identified another 14 positive feces from the remained 25 stool samples which absence of worms.Conclusions:The developed multiplex PCR shows advantages in fast diagnosis and large-scale epidemiological investigation,which proven to be a promising tool utilized in clinic and surveillance system.

Dog vaccination with EgM proteins against Echinococcus granulosus

Background:Dogs play a pivotal role in the transmission of cystic echinococcosis(CE),a zoonosis caused by the tapeworm Echinococcus granulosus.We showed previously that dogs vaccinated with two E.granulosus adult-worm specific proteins,EgM9 and EgM123,emulsified with Freund’s adjuvants induced significant protective efficacy in terms of reduction in worm burden and egg production after 45 days post-infection.It was not known whether this protection can be sustained using adjuvants suitable for use in dogs.Methods:Recombinant EgM9 and EgM123 were mixed with Quil A or ISCOMs for vaccinating dogs.After three vaccine injections,all the dogs were orally challenge-infected with 200000 protoscoleces of E.granulosus.After 45 days of infection,all the dogs were euthanized and necropsied for collecting and counting E.granulosus worms.Immunoglobins,including the IgG subclasses IgG1 and IgG2,were detected in the sera of vaccinated dogs by ELISA.To determine whether the protection efficacy could be maintained after 45 days post-infection,we implemented a longevity trial to count eggs in dog faeces for 170 days after infection.Results:The dogs vaccinated with EgM9 and EgM123 mixed with Quil A and ISCOMs showed similar protective efficacy as the proteins emulsified with Freund’s adjuvants in our previous study in terms of reduction of worms and eggs at 45 days post-infection.The longevity trial showed that EgM9 protein-vaccinated group released lower number of eggs per gram compared with the egg counts in the control dogs during the dog trial study.Conclusion:EgM9 and EgM123 are thus suitable vaccine candidates against E.granulosus infection in dogs.

Molecular characterization of a signal-regulated kinase homolog from Echinococcus granulosus

Background Cystic echinococcosis due to Echinococcus granulosus （E. granulosus） is one of the most important chronic helminthic diseases, especially in sheep/cattle-raising regions. The larval stage of the parasite forms a cyst that grows in the liver, lung, or other organs ofthe host. To ensure a long life in the host tissues, the parasite establishes complex inter-cellular communication systems between its host to allow its differentiation toward each larval stage. Recent studies have reported that this communication is associated with the extracellular signal-regulated kinase （ERK） mitogen-activated protein kinase cascade in helminth parasites, and in particular that these protein kinases might serve as effective targets for a novel chemotherapy for cystic echinococcosis. The aim of the present study investigated the biological function of a novel ERK ortholog from E. granulosus, EgERK. Methods DNA encoding EgERK was isolated from protoscolices of E. granulosus and analyzed using the LA Taq polymerase chain reaction （PCR） approach and bioinformatics. Reverse transcription PCR （RT-PCR） was used to determine the transcription level of the gene at two different larval tissues. Western blotting was used to detect levels of EgERK protein. The expression profile of EgERK in protoscolices was examined by immunofluorescence. Results We cloned the entire Egerk genomic locus from E. granulosus. In addition, two alternatively spliced transcripts of Egerk, Egerk-A, and Egerk-B were identified. Egerk-A was found to constitutively expressed at the transcriptional and protein levels in two different larval tissues （cyst membranes and protoscol（ces）. Egerk-A was expressed in the tegumental structures, hooklets, and suckers and in the tissue surrounding the rostellum of E. granulosus protoscolices. Conclusions We have cloned the genomic DNA of a novel ERK ortholog from E. granulosus, EgERK （GenBank ID HQ585923）, and found that it is constitutively expressed in cyst membrane and protoscolex. These findings will be useful in further study of the biological functions of the gene in the growth and development of Echinococcus and will contribute to research on novel anti-echinococcosis drug targets.

EFFECT OF ANTIHYDATID DRUGS ON CARBOHYDRATE METABOLISM OF METACESTODE OF ECHINOCOCCUS GRANULOSUS

A biochemical some enzymes of glycolysis and a partial reversed tricarboxylic acid cycle together with hydrolytic enzymes in the cyst wall of Echinococcus granulosus was carried out. Lactate dehydrogenase (LDH), pyruvate kinase (PK), phosphoenolpyruvate carboxykinase (PEPCK), and adenosine triphosphatase (ATPase) showed their high level of activity, suggesting that the proliferation of E. granulosus cyst wall is an energy-dependent process and the major pathways for glucose metabolism is glycolysis. Treatment of E. granulosus-in-fected mice with mebendazole and albendazole resulted in marked inhibition of PK, PEPCK and ATPase of E. granulosus cyst wall, whereas praziquantel had no effect, indicating that PK, PEPCK, and ATPase might be chemotherapeutic targets and the differences in the inhibitory effects might account for the efficacy of the three antihydatid drugs.

Genetic variation of the 8-kDa glycoprotein family from Echinococcus granulosus, Taenia multiceps and Taenia hydatigena

Background Echinococcosis, coenurosis and cysticercosis are debilitating diseases which prevail in China. Immunological diagnosis of metacestodosis is important in disease control. The 8-kDa glycoproteins from taeniid cestodes have successfully been used for diagnosis of human cysticercosis in immunological assays. The aim of the present study was to investigate genetic variations and phylogenetic relationships of the 8-kDa proteins for evaluating the possibility of utilizing these proteins as diagnostic antigens for other metacestode infections. Methods The genes and complementary DNAs （cDNAs） encoding the 8-kDa proteins from Echinococcus （E.） granulosus, Taenia （T.） multiceps and T. hydatigena were amplified using PCR method. Their amplicons were cloned into the vector pMD18 and the positive clones were sequenced. Sequence data were analyzed with the SeqMan program, and sequence homology searches were performed using the BLAST program. Alignments were conducted using the ClustalX program, and the phylogenetic analyses were performed with the Protein Sequences Program and the Puzzle Program using the Neighbor-joining method. Results Fifteen, 18 and 22 different genomic DNA sequences were identified as members of the 8-kDa protein gene family from E. granulosus, T. multiceps and T. hydatigena, respectively. Eight, four and six different cDNA clones respectively from E. granulosus, T. multiceps and T. hydatigena were characterized. Analysis of these sequences revealed 54 unique 8-kDa protein sequences. Phylogenetic trees demonstrated that the taeniid 8-kDa proteins are clustered into eight clades at least： Ts18, Ts14, TsRS1, TsRS2, T8kDa-1, T8kDa-2, T8kDa-3 and T8kDa-4. Conclusion We found that the gene family encoding for the taeniid 8-kDa antigens is comprised of many members with high diversity, which will provide molecular evidence for cross-reaction or specific reaction among metacestode infections and may contribute to the development of promising immunological methods for diagnosis of metacestodosis.

Biliary fistula and late recurrence of liver hydatid cyst:Role of cystobiliary communication:A prospective multicenter study

BACKGROUND Hydatid cyst disease(HCD)is common in certain locations.Surgery is associated with postoperative biliary fistula(POBF)and recurrence.The primary aim of this study was to identify whether occult cysto-biliary communication(CBC)can predict recurrent HCD.The secondary aim was to assess the role of cystic fluid bilirubin and alkaline phosphatase(ALP)levels in predicting POBF and recurrent HCD.AIM To identify whether occult CBC can predict recurrent HCD.The secondary aim was to assess the role of cystic fluid bilirubin and ALP levels in predicting POBF and recurrent HCD.METHODS From September 2010 to September 2016,a prospective multicenter study was undertaken involving 244 patients with solitary primary superficial stage cystic echinococcosis 2 and cystic echinococcosis 3b HCD who underwent laparoscopic partial cystectomy with omentoplasty.Univariable logistic regression analysis assessed independent factors determining biliary complications and recurrence.RESULTS There was a highly statistically significant association(P≤0.001)between cystic fluid biochemical indices and the development of biliary complications(of 16 patients with POBF,15 patients had high cyst fluid bilirubin and ALP levels),where patients with high bilirubin-ALP levels were 3405 times more likely to have biliary complications.There was a highly statistically significant association(P≤0.001)between biliary complications,biochemical indices,and the occurrence of recurrent HCD(of 30 patients with recurrent HCD,15 patients had high cyst fluid bilirubin and ALP;all 16 patients who had POBF later developed recurrent HCD),where patients who developed biliary complications and high bilirubin-ALP were 244.6 and 214 times more likely to have recurrent hydatid cysts,respectively.CONCLUSION Occult CBC can predict recurrent HCD.Elevated cyst fluid bilirubin and ALP levels predicted POBF and recurrent HCD.

Liver cystic echinococcosis and human host immune and autoimmune follow-up:A review

Cystic echinococcosis(CE) is an infectious disease caused by the larvae of parasite Echinococcus granulosus(E.granulosus).To successfully establish an infection,parasite release some substances and molecules that can modulate host immune functions,stimulating a strong anti-inflammatory reaction to carry favor to host and to reserve self-survival in the host.The literature was reviewed using MEDLINE,and an open access search for immunology of hydatidosis was performed.Accumulating data from animal experiments and human studies provided us with exciting insights into the mechanisms involved that affect all parts of immunity.In this review we used the existing scientific data and discuss how these findings assisted with a better understanding of the immunology of E.granulosus infection in man.The aim of this study is to point the several facts that challenge immune and autoimmune responses to protect E.granulosus from elimination and to minimize host severe pathology.Understanding the immune mechanisms of E.granulosus infection in an intermediate human host will provide,we believe,a more useful treatment with immunomodulating molecules and possibly better protection from parasitic infections.Besides that,the diagnosis of CE has improved due to the application of a new molecular tool for parasite identification by using of new recombinant antigens and immunogenic peptides.More studies for the better understanding of the mechanisms of parasite immune evasion is necessary.It will enable a novel approach in protection,detection and improving of the host inflammatory responses.In contrast,according to the "hygiene hypothesis",clinical applications that decrease the incidence of infection in developed countries and recently in developing countries are at the origin of the increasing incidence of both allergicand autoimmune diseases.Thus,an understanding of the immune mechanisms of E.granulosus infection is extremely important.

Pericyst: The outermost layer of hydatid cyst

Hydatid disease,caused by the parasite Echinococcus granulosus,mostly affects the liver and the lungs with hydatid cysts which consist of three layers:(1)the outer pericyst;(2)the middle laminated membrane;and(3)the inner germinal layer.Pericyst,as the outermost layer of the hydatid cyst,is made by host cells encasing the hydatid cyst.An extremely close interaction exists between this host tissue and the parasite,and any degenerative changes of the pericyst would result in hydatid cyst degeneration or rupture.The pericyst plays an undeniably important role in the development and survival of the hydatid cyst.

Evaluating the effect of Myrtus communis on programmed cell death in hydatid cyst protoscolices

ObjectiveTo evaluate the possible involvement of programmed cell death strategy in hydatid cyst protoscolices following treatment with Myrtus communis (M. communis) as an herbal medicine.MethodsProtoscolices were aseptically collected from sheep liver hydatid cysts. Evaluating the effect of M. communis extract on programmed cell death and increased activity of caspases 3, 8, and 9 in hydatid cyst protoscolices was conducted by treating the protoscolices with different concentration (5, 50, and 100 mg/mL) of M. communis extract at 37 °C and 5% CO2 for 4 h by using the Bradford test and ELISA commercial kits.ResultsThe extract of M. communis at all concentrations led to initiation of programmed cell death in protoscolices and this effect, was only significant at 50 and 100 mg/mL concentrations, compared to the negative control (P < 0.05). Also, the activity of caspases 3, 8, and 9 in hydatid cyst protoscolices, was shown that the extract at all 3 concentrations could only increase the activity of caspases 3 and 9. Moreover, a significant increase in the activity of caspase 3 was only observed at concentrations 50 and 100 mg/mL by 37.00% and 66.19% while a significant increase in the activity of caspase 9 at the same concentrations was observed by 20.89% and 63.67%, respectively (P < 0.05).ConclusionsThe extract of M. communis at different concentrations could increase the activity of caspases 3 and 9 and caused programmed cell death in hydatid cyst protoscolices however, this effect was significant at high concentrations of the extract.

Identification of a gene engineering antibody against cystic echinococcosis in liver

OBJECTIVE: To identify a gene engineering antibody against cystic echinococcosis in liver. METHODS: A single chain of variable fragment of human antibodies (ScFvs) was selected from the library by using affinity selection technique with the recombinant antigen on solid surface. The positive clones were demonstrated by ELISA and their DNA sequences were also determined. RESULTS: The DNA sequence data showed that the antibody gene is composed of 768bp. In addition, a specific combination capacity with recombinant Echinococcus granulosus antigen B (r-EgB) was demonstrated by ELISA. CONCLUSION: The obtained gene engineering antibody against r-EgB may have potential implications in immunological treatment and drug targeting delivery.

Mediastinal and Pericardial Hydatidosis—A Case Report and Review of Literature

Hydatid disease caused by Echinococcus granulosus is endemic in Indian subcontinent and a common surgical problem. Although occurrence of hydatid cyst is common in liver and lungs, it can be encountered in almost every part of the body. Combined mediastinal and pericardial hydatid disease is a rare occurrence and only a few cases have been reported in the literature. Patients with hydatid cysts are usually asymptomatic. Our case report demonstrates a 57-year-old female patient who presented with chest pain and dyspnea on exertion for few months duration. Detailed imaging and laboratory investigation revealed a pericardial and mediastinal hydatid cyst. The patient underwent operation for curative excision. After surgery, the patient’s symptoms resolved and his clinical status improved.

Estimating the prevalence of Echinococcus in domestic dogs in highly endemic for echinococcosis

Background:Cystic echinococcosis(CE)and alveolar echinococcosis(AE)are highly endemic in Xiji County of Ningxia Hui Autonomous Region(NHAR)in China where the control campaign based on dog de-worming with praziquantel has been undertaken over preceding decades.This study is to determine the current prevalence of Echinococcus granulosus and E.multilocularis in domestic dogs and monitor the echinococcosis transmission dynamics.Methods:Study villages were selected using landscape patterns(Geographic Information System,GIS)for Echinococcus transmission“hot spots”,combined with hospital records identifying risk areas for AE and CE.A survey of 750 domestic dogs,including copro-sampling and owner questionnaires,from 25 selected villages,was undertaken in 2012.A copro-multiplex PCR assay was used for the specific diagnosis of E.granulosus and E.multilocularis in the dogs.Data analysis,using IBM SPSS Statistics,was undertaken,to compare the prevalence of the two Echinococcus spp.in dogs between four geographical areas of Xiji by theχ^(2)test.Univariate analysis of the combinations of outcomes from the questionnaire and copro-PCR assay data was carried out to determine the significant risk factors for dog infection.Results:The highest de-worming rate of 84.0%was found in the northwest area of Xiji County,and significant differences(P<0.05)in the de-worming rates among dogs from the four geographical areas of Xiji were detected.The highest prevalence(19.7%,59/300)of E.multilocularis occurred in northwest Xiji,though the highest prevalence(18.1%,38/210)of E.granulosus occurred in southwest Xiji.There was no significant difference(P>0.05)in the prevalence of E.granulosus in dogs from the northwest,southwest,northeast,and southeast of Xiji,but there were significant differences(P<0.05)between dogs infected with E.multilocularis from the four areas.None of the other independent variables was statistically significant.Conclusions:The results from this study indicate a high prevalence of both E.granulosus and E.muiltilocularis in dogs in Xiji County,NHAR.Transmission of E.multilocularis was more impacted by geographical risk-factors in Xiji County than that of E.granulosus.Dogs have the potential to maintain the transmission of both species of Echinococcus within local Xiji communities,and the current praziquantel dosing of dogs appears to be ineffective or poorly implemented in this area.

Efficacy of radiotherapy for the treatment of cystic echinococcosis in naturally infected sheep

Background:Radiotherapy is commonly used to treat cancers.To date,there has been no study focusing on the effects of radiotherapy on hydatid disease in large animals.In this study,we aim to investigate the efficiency and safety of radiotherapy for treating hydatid disease caused by Echinococcus granulosus in naturally infected sheep.Methods:Ultrasound was used to screen naturally infected sheep in an echinococcosis endemic area in Xinjiang,China.A computer tomography(CT)scan confirmed the presence of hydatid cysts.Twenty sheep naturally infected with E.granulosus in the liver and/or lungs were randomly assigned into four groups receiving no irradiation,or X-ray irradiation of low(30 Gy),medium(45 Gy),and high dose(60 Gy),respectively.After three months of radiotherapy,a CT scan was performed to measure the changes in the cysts.The hepatic parasite cysts and host tissues were collected for histology and gene expression analysis.Results:In the animals subject to irradiation,no significant differences were observed in their appetite,daily activities,and weight before and after radiotherapy.Severe calcification was noticed in the cysts subject to a high dose of radiation compared with the groups subject to low and medium doses.Hematoxylin and eosin staining showed that irradiation contributed to the damage of the cyst structure and nucleus in the germinal layers.Quantitative PCR demonstrated that expression of TPX and HSP70 significantly decreased in a dose-dependent manner(P<0.05).The expression of the EPC1 decreased in the medium-and high-dose groups compared with the low-dose group(P<0.05).Meanwhile,the expression of radiation-related apoptosis genes caspase-3 and Gadd45 decreased with an increase in the irradiation dose.Conclusions:Radiotherapy is an option with satisfactory efficiency and safety for treating cystic echinococcosis in sheep with partial response or stable disease at month 3.In future,inhibition of cystic activity using radiotherapy may serve as a new regimen for treating hydatid disease.