From cercariae to chronic inflammation: understanding schistosome infection and host immune responses

TL;DR

This paper reviews how Schistosoma parasites manipulate the human immune system to cause chronic inflammation and disease.

Contribution

The paper provides a comprehensive review of host–parasite immune interactions across all stages of schistosomiasis.

Findings

Schistosoma modulates the host immune system to evade detection and persist long-term.

Chronic inflammation results from immune responses to trapped parasite eggs in host tissues.

Understanding stage-specific immune dynamics could inform new treatment strategies.

Abstract

Schistosomiasis is a parasitic disease caused by trematodes of the genus Schistosoma, typically found in tropical and subtropical freshwater environments. Recognized by the World Health Organization as a major emerging disease, schistosomiasis is characterized by the parasite’s ability to modulate and evade the host immune system, enabling long-term persistence within the human body. This immunomodulation not only supports chronic infection but also drives disease pathology, particularly through granulomatous inflammation surrounding parasite eggs trapped in host tissues. A deeper understanding of the immunological interactions between Schistosoma spp. and the human host is crucial for guiding the development of novel therapies. This review aims to delineate the immunological dynamics of Schistosoma infection across different stages of disease progression, with a particular focus on site-specific host–parasite interactions that shape both the acute and chronic phases of schistosomiasis.

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