Alveolar Echinococcosis and Cystic Echinococcosis: Advances in the 21st Century

Dear Colleagues,

Echinococcosis, one of the world’s most lethal parasitoses, remains a challenge for clinicians and public health systems in affected countries. The two main types of the disease are cystic echinococcosis (CE) and alveolar echinococcosis (AE). Despite insight from experimental, epidemiological, and clinical research, we still are far from fully understanding AE and CE. Therefore, we would like to invite you, as experts in this field, to add a piece to the puzzle and share your research results on AE and CE. Compiling and integrating our research will improve our ability to prevent, diagnose, and treat these diseases and hopefully reduce their burden. This topic aims to share research with clinical implications from all AE- and CE-affected countries. More precisely, the focus lies on the following research questions: How to make the first diagnosis of AE and CE easier. What are simple and reliable biomarkers to identify AE and CE? How can new imaging techniques help to establish the diagnosis? When is a biopsy required and how can the examination be conducted? Histology, immunohistology, or nucleic acid detection—quo vadis? Diagnosis prompts treatment—or does it? How can we strike the right balance between action and cautious restraint? How can we separate active and inactive disease? How can we evaluate treatment response? Is the PNM classification a reliable prognostic tool? When is it appropriate to delay or pause treatment (“watch and wait”)? Therapy in AE and CE: crossroads, dead-end, or roadworks? How should we choose a treatment option and overcome the current limitations? If benzimidazoles fail with AE, what treatment options are left? How does treatment differ in vulnerable groups, e.g., the immunocompromised? When are conservative treatment and surgery the best choices? When is percutaneous treatment indicated for CE? What are the strengths and limitations of different surgical and interventional techniques? How can resection margin and perioperative treatment with benzimidazoles affect the long-term outcome? Liver transplantation as the ultima ratio with AE—quo vadis? From bench to bedside: how clinicians learn from basic research. How does the host’s immune system control AE and CE? Which host factors contribute to a stable disease and which do not? Is there a difference in the pathogenicity/infectivity of different genetic variants? What are the underlying mechanisms of benzimidazole intolerance or suspected resistance? Looking at the greater picture: how can we reduce the burden of disease? Understanding the One Health dynamics of AE and CE: what are the risk factors for transmission? What is the geographical distribution and relative frequency of different causative species and genotypes? Are there differences in host predilection? Mass screening, slaughter hygiene, animal vaccination, personal hygiene promotion, dog/fox treatment—what are successful and cost-effective public health strategies?

Dr. Thomas Romig
Dr. Beate Grüner
Topic Editors