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Infection with helminth parasites remains a persistent public health problem in developing countries. Three of these pathogens, the liver flukes  Clonorchis sinensis ,  Opisthorchis viverrini  and the blood fluke  Schistosoma haematobium,  are of particular concern due to their classification as Group 1 carcinogens: infection with these worms is carcinogenic. Using liquid chromatography-mass spectrometry (LC-MS/MS) approaches, we identified steroid hormone like (e.g., oxysterol-like, catechol estrogen quinone-like, etc.) metabolites and related DNA-adducts, apparently of parasite origin, in developmental stages including eggs of  S. haematobium , in urine of people with urogenital schistosomiasis, and in the adult stage of  O. viverrini . Since these kinds of sterol derivatives are metabolized to active quinones that can modify DNA, which in other contexts can lead to breast and other cancers, helminth parasite associated sterols might induce tumor-like phenotypes in the target cells susceptible to helminth parasite associated cancers, i.e., urothelial cells of the bladder in the case of urogenital schistosomiasis and the bile duct epithelia or cholangiocytes, in the case of  O. viverrini  and  C. sinensis . Indeed we postulate that helminth induced cancers originate from parasite estrogen-host epithelial/urothelial cell chromosomal DNA adducts, and here we review recent findings that support this conjecture.

Schistosome and liver fluke derived catechol-estrogens and helminth associated cancers