Liver Fluke Induces Cholangiocarcinoma (original) (raw)
Figure 5
Proposed Mechanisms of Opisthorchis-Derived CCA Initiation
The three proposed pathways linking the parasite to CCA initiation are mechanical damage (in yellow), molecular products (in blue), and immunopathology (in green). Combined, these mechanisms result in several common elements (purple) that all lead to DNA damage. The inhibition of a normal DNA damage response is the final oncogenic factor proposed to dramatically increase the likelihood of a malignant transformation. This invariably leads to progression of CCA. (Adapted from [10].) The photographs underneath the schematic show two livers with advanced CCA.