Abstract

BackgroundInfection with Schistosoma spp. affects more than 258 million people worldwide. Current treatment strategies are mainly based on the anthelmintic Praziquantel, which is effective against adult worms but neither prevents re-infection nor cures severe liver damage. The best long-term strategy to control schistosomiasis may be to develop an immunization. Therefore, we designed a two-step Schistosoma mansoni infection model to study the immune-stimulating effect of a primary infection with either male or female cercariae, measured on the basis of TH1/TH2-response, granuloma size and hepatic fibrosis after a secondary bisexual S. mansoni challenge.Methodology/Principle findingsAs a first step, mice were infected with exclusively female, exclusively male, or a mixture of male and female S. mansoni cercariae. 11 weeks later they were secondarily infected with male and female S. mansoni cercariae. At week 19, infection burden, granuloma size, collagen deposition, serum cytokine profiles and the expression of inflammatory genes were analyzed. Mice initially infected with female S. mansoni cercariae displayed smaller hepatic granulomas, livers and spleens, less hepatic fibrosis and higher expression of Ctla4. In contrast, a prior infection with male or male and female S. mansoni did not mitigate disease progression after a bisexual challenge.Conclusions/SignificanceOur findings provide evidence that an immunization against S. mansoni is achievable by exploiting gender-specific differences between schistosomes.

Highlights

  • The blood flukes of the genus Schistosoma spp. are among the world’s most prevalent human helminthic parasites

  • Schistosomiasis remains a major cause of morbidity and mortality, and in the tropics and subtropics in particular, infection rates are high

  • The root cause of disease is a granulomatous hypersensitivity reaction to parasite eggs entrapped within the intestinal wall and small liver sinusoids

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Summary

Introduction

The blood flukes of the genus Schistosoma spp. are among the world’s most prevalent human helminthic parasites. According to the WHO over 258 million people are currently receiving preventive therapy, mostly to avoid severe long-term liver damage [1]. Entrapped within the intestinal wall and small liver sinusoids they provoke an inflammatory, granulomatous reaction that is mainly caused by CD4+ T cells of the subtype 2 and alternatively activated macrophages [3]. This repair response suppresses initial TH1 inflammation but results in hepatic fibrosis (e.g. Symmer’s pipe stem fibrosis), portal hypertension and its clinical sequelae, ascites and esophageal varices [4]. We designed a two-step Schistosoma mansoni infection model to study the immune-stimulating effect of a primary infection with either male or female cercariae, measured on the basis of TH1/TH2-response, granuloma size and hepatic fibrosis after a secondary bisexual S. mansoni challenge

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