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Immunopathogenesis of human schistosomiasis

Authors

  • M. L. BURKE,

    1. Molecular Parasitology Laboratory, Division of Infectious Diseases and Immunology, The Queensland Institute of Medical Research, Herston, Queensland, Australia;
    2. The School of Population Health, The University of Queensland, Herston, Queensland, Australia;
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  • M. K. JONES,

    1. Molecular Parasitology Laboratory, Division of Infectious Diseases and Immunology, The Queensland Institute of Medical Research, Herston, Queensland, Australia;
    2. The School of Veterinary Science, The University of Queensland, St Lucia, Queensland, Australia
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  • G. N. GOBERT,

    1. Molecular Parasitology Laboratory, Division of Infectious Diseases and Immunology, The Queensland Institute of Medical Research, Herston, Queensland, Australia;
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  • Y. S. LI,

    1. Molecular Parasitology Laboratory, Division of Infectious Diseases and Immunology, The Queensland Institute of Medical Research, Herston, Queensland, Australia;
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  • M. K. ELLIS,

    1. Molecular Parasitology Laboratory, Division of Infectious Diseases and Immunology, The Queensland Institute of Medical Research, Herston, Queensland, Australia;
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  • D. P. McMANUS

    1. Molecular Parasitology Laboratory, Division of Infectious Diseases and Immunology, The Queensland Institute of Medical Research, Herston, Queensland, Australia;
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  • Disclosures: M. L. Burke, M. K. Jones, G. N. Gobert, Y.S. Li, M. K. Ellis, D P. McManus – None

: Donald McManus, Molecular Parasitology Laboratory, Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Herston, QLD 4029, Australia (e-mail: donald.mcmanus@qimr.edu.au).

SUMMARY

Schistosomiasis continues to be a significant cause of parasitic morbidity and mortality worldwide. This review considers the basic features of the pathology and clinical outcomes of hepatointestinal and genitourinary schistosomiasis, presents an overview of the numerous studies on animal models that have clarified many of the immunopathological features, and provides insight into our current understanding of the immunopathogenesis and genetic control of human schistosomiasis. In murine schistosomiasis, pathology is induced by a CD4+ Th2 driven granulomatous response directed against schistosome eggs lodged in the host liver. The Th2 cytokines IL-4 and IL-13 drive this response, whereas IL-10, IL13Rα2, IFN-γ and a subset of regulatory T-cells act to limit schistosome induced pathology. A variety of cell types including hepatic stellate cells, alternatively activated macrophages and regulatory T-cells have also been implicated in the pathogenesis of schistosomiasis. Current knowledge suggests the immunopathogenic mechanisms underlying human schistosomiasis are likely to be similar. The review also considers the future development of anti-pathology schistosome vaccines. As fibrosis is an important feature of many other diseases such as Crohn's disease and sarcoidosis, a comprehensive understanding of the cellular and molecular mechanisms involved in schistosomiasis may also ultimately contribute to the development an effective disease intervention strategy for other granulofibrotic diseases.

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