Abstract

Parasitic infections are prevalent in both tropical and subtropical areas. Most of the affected and/or exposed populations are living in developing countries where control measures are lacking or inadequately applied. Although significant progress has been made in our understanding of the immune response to parasites, no definitive step has yet been successfully done in terms of operational vaccines against parasitic diseases. Evidence accumulated during the past few years suggests that the pathology observed during parasitic infections is in part due to deregulation of normal components of the immune system, mainly cytokines, antibodies, and immune effector cell populations. A large number of studies that illustrate how parasites can modify the host immune system for their own benefit have been reported in both metazoan and protozoan parasites. The first line of defense against foreign organisms is barrier tissue such as skin, humoral factors, for instance the complement system and pentraxin, which upon activation of the complement cascade facilitate pathogen recognition by cells of innate immunity such as macrophages and DC. However, all the major groups of parasites studied have been shown to contain and/or to release factors, which interfere with both arms of the host immune system. Even some astonishing observations relate to the production by some parasites of orthologues of mammalian cytokines. Furthermore, chronic parasitic infections have led to the immunosuppressive environment that correlates with increased levels of myeloid and T suppressor cells that may limit the success of immunotherapeutic strategies based on vaccination. This minireview briefly analyzes some of the current data related to the regulatory cells and molecules derived from parasites that affect cellular function and contribute to the polarization of the immune response of the host. Special attention is given to some of the data from our laboratory illustrating the role of immunomodulatory factors released by protozoan parasites, in the induction and perpetuation of chronic disease.

Highlights

  • There is increasing evidence that immune mechanisms are involved in the pathogenesis of many parasitic infections

  • In most cases a state of immunosuppression can be evidenced. This hyporesponsiveness to antigen-specific and polyclonal stimuli in chronic parasitic infections could be related to immunosuppressive cytokines (i.e., IL-10 and TGF-β) secreted by antigen presenting cells and regulatory T cells (Treg cells)

  • A number of years ago, we have shown that total antigens from O. volvulus (OVA) markedly inhibited the proliferation of normal human lymphocytes stimulated with polyclonal activators such as phytohaemagglutinin (PHA)

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Summary

INTRODUCTION

There is increasing evidence that immune mechanisms are involved in the pathogenesis of many parasitic infections. A growing list of parasite-derived molecules able to exert immunomodulatory activities on the cells of the innate immunity leading to such polarized cytokine secretion has been reported [1, 2] These immunosuppressive regulatory responses resulting from repeated exposure to pathogens and/or their released products have been postulated to be responsible for protection against inflammatory diseases such as allergy or autoimmunity leading to the germless theory of allergic diseases and the hygiene hypothesis [3, 4]. The parasites cannot only induce the production of host immunomodulatory lipids, the best characterized being the endogenous eicosanoids, but are able to synthesize/secrete their own glycoproteins and lipids, which in turn activate cells of innate immunity towards the anti-inflammatory cytokine response This physiological microenvironment may favor the development of Treg cells. The outcome of a parasitic infection will depend on the final balance of the protective and pathological properties of the cytokine network

INDUCTION OF SUPPRESSOR CELLS
Induction of apoptosis in the host immune cells
PD-1 as active suppressor of T regulatory cells
Lipids
Polysaccharides
Polypeptides
Concluding remarks
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