Abstract
Hookworm infection is a major public health problem that threatens about 500 million people throughout tropical areas of the world. Adult hookworms survive for many years in the host intestine, where they suck blood, causing iron deficiency anemia and malnutrition. Numerous molecules, named excretory/secretory (ES) products, are secreted by hookworm adults and/or larvae to aid in parasite survival and pathobiology. Although the molecular cloning and characterization of hookworm ES products began 25 years ago, the biological role and molecular nature of many of them are still unclear. Hookworm ES products, with distinct structures and functions, have been linked to many essential events in the disease pathogenesis. These events include host invasion and tissue migration, parasite nourishment and reproduction, and immune modulation. Several of these products represent promising vaccine targets for controlling hookworm disease and therapeutic targets for many inflammatory diseases. This review aims to summarize our present knowledge about hookworm ES products, including their role in parasite biology, host-parasite interactions, and as vaccine and pharmaceutical targets and to identify research gaps and future research directions in this field.
Highlights
Hookworms are soil-transmitted intestinal nematodes that infect nearly 500 million people in tropical regions of South America, Africa and Asia [1]
Advances in molecular biology over the last 25 years resulted in the identification of numerous hookworm ES products, with diverse structures and functions
Many ES molecules help in host invasion, tissue migration, blood-feeding, nutrient acquisition, reproduction, embryo-development, host defense and immune modulation
Summary
Hookworms are soil-transmitted intestinal nematodes that infect nearly 500 million people in tropical regions of South America, Africa and Asia [1]. These blood-feeding nematodes cause one of the most debilitating neglected tropical disease called hookworm disease. This disease resulted in four million disability-adjusted life years (DALYs) and up to USD139 billion annual economic productivity losses [2]. Most human hookworm infections are caused by Necator americanus, Ancylostoma duodenale and Ancylostoma ceylanicum. Hookwormassociated clinical symptoms, such as abdominal pain, diarrhea, and protein malnutrition, commonly occur. The principal clinical symptom of hookworm disease is iron deficiency anemia (IDA) because of blood
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