The Experiment Research Of Comprehensive Interventional Treatment On Hepatic Alveolar Echinococcosis In Rats

Objective: To evaluate the effectiveness of the endovascular treatment, radiofrequency ablation and antiangiogenic therapy on hepatic alveolar echinococcosis in rats. Methods:To copy hepatic alveolar echinococcosis animal models with Wistar rats. Endovascular treatment is divided into five groups, model control group, oral group, intravenous group,two groups of endovascular treatment, the infusion of hepatic artery and portal vein group. To observe alveolar hydatid wet weight, pathological changes, HIF-1?, VEGF-A,VEGF-C, microvessel density(MVD), lymphatic microvessel density(LVD) after the treatment with albendazole nanospheres. Radiofrequency ablation experiment divided into two groups, model control group and the experimental group. To observe alveolar hydatid wet weight, pathological changes, serum HIF-1?, serum and tissue VEGF, MVD and LVD after radiofrequency ablation. To observe dynamic changes of VEGF, LVD, Fox P3+ Treg cells and pathological images after antiangiogenic therapy, which divided into two groups,model control group and hepatic arterial infusion bevacizumab group. Results: The analysis of variance for repeated measurement data of the ALT / AST and white blood cells at six time points show significant difference post endovascular treatment(P<0.05),what caused white blood cell transient increase and liver function transient injury.There is no significant difference at hepatic alveolar echinococcosis sac wet weight(P>0.05). Pathological features are mainly degeneration and necrosis after endovascular treatment, which show a significant difference compared with oral group(P <0.05). The albendazole sulfoxide highest treatment concentrated on liver in endovascular groups,relative to plasma and alveolar hydatid sac with a statistically significant difference(P<0.05). The level of VEGF-a/VEGF-c,HIF-1?, MVD, LVD in Endovascular treatment groups significantly higher than the model group. After radiofrequency ablation, white blood cell transient increased and liver function transient injured with significant difference compared with control group(P<0.05). hepatic alveolar echinococcosis sac wet weight dropped significantly(P<0.05), and the rate is 32.16%. The typical pathological characteristic is necrosis. Serum VEGF, MVD and LVD decreased significantly(P<0.05).HIF-1?increased significantly(P<0.05). In the antiangiogenic therapy, transaminase curve shows no significant difference(P>0.05). Pathological observation did not change significantly. The VEGF level of experiment group declined first then up. After7 days,VEGF was significantly lower(P<0.05),14 days at a minimum level(P<0.05), then increased to the control group level at 28 days(P>0.05). The serum and hepatic alveolar echinococcosis infiltrative belt VEGF displayed the same variation. Fox P3+ Treg cells decreased, while LVD no significant change.Conclusion: Although endovascular treatment caused transient liver injury, it proved unique advantages for the outstanding liver-targeting and the albendazole sulfoxide concentration in hepatic alveolar echinococcosis sac cross reference to oral and intravenous therapy. Radiofrequency ablation therapy focused on the exploration and construction radiofrequency ablation method on hepatic alveolar echinococcosis in rats, considered a kind of effective treatment method to destroy falveolar echinococcus, by analysis pathological images, VEGF,HIF-1?. Antiangiogenic therapy with infusion bevacizumab via hepatic artery, can inhibit the angiogenesis effectively induced by VEGF, and normalize MVD and LVD at hepatic alveolar echinococcosis infiltrative belt. The therapy also bate the expression of Fox P3+Treg, reverse the immune tolerance, thus regulating the immune killing function.