Abstract
Schistosomiasis is a severe parasitic disease, endemic in 74 developing countries with up to 600 million people infected and 800 million, mostly children, at risk of contracting the disease following infection predominantly with Schistosoma mansoni, Schistosoma haematobium, or Schistosoma japonicum. The disease burden is estimated to exceed 70 million disability-adjusted life-years, and leads to remarkably high YLD (years lived with disability) rates. Even more importantly, people with schistosomiasis are highly susceptible to malaria, tuberculosis, and hepatic and acquired immunodeficiency viruses. There is only one drug, praziquantel, currently available for treatment and it has high efficacy, low cost, and limited side effects. However, only 13% of the target population has received the drug, and those treated are at continuous risk of reinfection necessitating repeated drug administration and the emergence of drug-resistant parasites is a constant threat (1). Currently there is no vaccine. The a priori requirements for discovery of a vaccine formulation include the following: identification of protective key immune players in humans; characterization and isolation of target antigens; establishment of efficacy in terms of reduction of parasite burden as well as amelioration of immunopathology; establishment of safety; and finally, provision of considerable funds along with physical infrastructure and qualified personnel to carry out clinical trials.
Highlights
Specialty section: This article was submitted to Immunotherapies and Vaccines, a section of the journal Frontiers in Immunology
The target of >40% protection has been achieved with some schistosome molecules such as fatty acid binding protein (Sm14), paramyosin, calpain large subunit (Sm80), superoxide dismutase (SOD), glutathione S-transferase (GST), glyceraldehyde 3-phosphate dehydrogenase, and cysteine peptidases [2]
A remarkable finding in the study was the implication that type 2 (IgG1 and IgE) and not type 1-related antibodies are critical for human resistance against S. haematobium reinfection
Summary
Specialty section: This article was submitted to Immunotherapies and Vaccines, a section of the journal Frontiers in Immunology. The a priori requirements for discovery of a vaccine formulation include the following: identification of protective key immune players in humans; characterization and isolation of target antigens; establishment of efficacy in terms of reduction of parasite burden as well as amelioration of immunopathology; establishment of safety; and provision of considerable funds along with physical infrastructure and qualified personnel to carry out clinical trials.
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