Opisthorchis or liver flukes are parasitic flatworms that are ingested with incompletely cooked food, especially infected fresh water fish, or due to poor sanitation. When ingested, the worms migrate from the small intestine into the bile duct where they can live for many years and produce eggs, which are excreted with the human feces.
Opisthorchis felineus is common in Russia where it is estimated that 1.5 million people are infected while Opisthorchis sinensis (or Clonorchis sinensis) and Opisthorchis viverrini are common in south and Southeast Asia. Especially in Laos and northeast Thailand the prevalence in humans is very high with roughly 10% of the population.
While infected people may show no symptoms, about 20 % have diarrhea, pain, lack of appetite, fatigue, jaundice, and/or fever.
In addition, Opisthorchis viverrini infections have been implicated in the etiology of malignant bile duct cancer (cholangiocarcinoma) in humans and have been categorized by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen. Cholangiocarcinoma is a metastatic tumor of epithelial cells derived from the bile duct, which is rapidly progressing and lethal. There is no treatment for the disease other than surgery, requiring the resection of the primary tumor and all metastases, and concomitant chemo- or radiation therapy.
The medical need for opisthorchiasis is early diagnosis. Many infected people do not show any symptoms that would make them consider seeing a doctor or get laborious and often difficult and expensive tests done to determine the cause of their problems. The parasite continues to produce eggs and enhances the chance for new worms going through their lifecycle and infecting other people. But even more importantly the parasite will continue increasing the risk for the development of cholangiocarcinoma. Drugs are available to fight the parasite even if these have side effects and are only moderately effective. If a cheap, simple, early mass diagnosis could be achieved through the development of a simple kit similar to a pregnancy test, targeted treatment of infected would become possible and the development of cholangiocarcinoma could be prevented. ReMedys is working with a consortium of different to this end.