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Thioredoxin reductase-1 and incidence of COVID-19 among cholangiocarcinoma patients in tropical endemic area

 Parasitic Disease Research Unit, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima Province, Thailand; Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India

Date of Submission18-Mar-2021
Date of Decision20-Mar-2021
Date of Acceptance28-Mar-2021
Date of Web Publication15-Feb-2022

Correspondence Address:
Viroj Wiwanitkit,
Parasitic Disease Research Unit, Institute of Medicine, SuranareeUniversity of Technology, Nakhon Ratchasima Province

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.jcrt_462_21

How to cite this URL:
Wiwanitkit V. Thioredoxin reductase-1 and incidence of COVID-19 among cholangiocarcinoma patients in tropical endemic area. J Can Res Ther [Epub ahead of print] [cited 2022 Nov 29]. Available from: https://www.cancerjournal.net/preprintarticle.asp?id=337713


Cholangiocarcinoma is a deadly cancer of biliary tract. It is highly prevalent in Southeast Asia and estimated incidence is nearly 4/100,000.[1] The patient usually presents with advanced disease and there is a very high mortality.[2] The important risk factor for cholangiocarcinoma is the liver fluke infection. During the COVID-19 outbreak, Indochina is affected. There are many millions of COVID-19 in this area and patient with malignancy is an important group of COVID-19 patients.[3] In this area, patients with various kinds of cancers are affected by COVID-19. Surprisingly, there is no COVID-19 patient with underlying cholangiocarcinoma despite cholangiocarcinoma is one of the most common cancers in this area. The study to assess underlying pathomechanism relating to a low incidence of COVID-19 among cholangiocarcinoma patients in this tropical endemic area is interesting.

Here, the authors would like to discuss on a possible explanation is relating to thioredoxin reductase-1. The liver fluke infection that causes cholangiocarcinoma can secrete thioredoxin reductase-1 protein.[4] This selnoprotein plays important anti-inflammatory role against damage induced by reactive oxygen species. In liver fluke-related cholangiocarcinoma, the malignant cell also expresses thioredoxin reductase-1. Indeed, the selenoprotein is an important target for COVID-19 management.[5] The anti-inflammatory effect due to thioredoxin reductase-1 from cholangiocarcinoma might explain the low incidence of severe COVID-19 in the area with high incidence of cholangiocarcinoma. Further research on this interesting issue is recommended.

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Conflicts of interest

There are no conflicts of interest.

 > References Top

Kamsa-Ard S, Luvira V, Suwanrungruang K, Kamsa-Ard S, Luvira V, Santong C, et al. Cholangiocarcinoma trends, incidence, and relative survival in khon kaen, thailand from 1989 through 2013: A population-based cancer registry study [J Epidemiol 29 (5) (2019) 197-204]. J Epidemiol 2020;30:108-9.  Back to cited text no. 1
Wiwanitkit V. Clinical findings among 62 Thais with cholangiocarcinoma. Trop Med Int Health 2003;8:228-30.  Back to cited text no. 2
Joob B, Wiwanitkit V. Cancerous patient with COVID-19: Note on data from the first 3-month period of disease. South Asian J Cancer 2020;9:120.  Back to cited text no. 3
Suttiprapa S, Loukas A, Laha T, Wongkham S, Kaewkes S, Gaze S, et al. Characterization of the antioxidant enzyme, thioredoxin peroxidase, from the carcinogenic human liver fluke, Opisthorchis viverrini. Mol Biochem Parasitol 2008;160:116-22.  Back to cited text no. 4
Taylor EW, Radding W. Understanding selenium and glutathione as antiviral factors in COVID-19: Does the Viral Mpro protease target host selenoproteins and glutathione synthesis? Front Nutr 2020;7:143.  Back to cited text no. 5


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