Lebens Michael, Sun Jia-Bin, Czerkinsky Cecil, Holmgren Jan
Göteborg University, Department of Medical Microbiology and Immunology, PO Box 435, SE-405 30 Gothenburg, Sweden.
Expert Rev Vaccines. 2004 Jun;3(3):315-28. doi: 10.1586/14760584.3.3.315.
Schistosomiasis remains an intractable problem in many parts of the world. Whereas the schistosome parasites cause little in the way of disease, their eggs become trapped in tissues of the host and elicit powerful and potentially damaging immune responses that are responsible for the pathology. Despite nearly four decades of effort there is still no effective vaccine against schistosomiasis, although a single vaccine candidate is undergoing clinical trials at present. Animal models have revealed much about disease progression and pathology. However, problems remain in identifying appropriate protective antigens to elicit immune responses that will attack the parasite but will not cross-react with egg antigens and thus increase the chance of developing severe chronic disease in individuals that have already been infected. This review summarizes the life-cycle of the parasite, current knowledge of pathogenesis and acquired immunity based on animal studies and observations in humans and the status of efforts in the vaccine development field.
血吸虫病在世界许多地区仍然是一个棘手的问题。虽然血吸虫寄生虫本身引起的疾病较少,但其虫卵会被困在宿主组织中,并引发强烈且可能具有破坏性的免疫反应,而正是这些免疫反应导致了病理变化。尽管经过了近四十年的努力,但目前仍没有有效的血吸虫病疫苗,不过有一种候选疫苗正在进行临床试验。动物模型已经揭示了许多关于疾病进展和病理的信息。然而,在确定合适的保护性抗原以引发免疫反应方面仍然存在问题,这种免疫反应既要攻击寄生虫,又不能与虫卵抗原发生交叉反应,从而增加已感染个体发展为严重慢性疾病的几率。这篇综述总结了寄生虫的生命周期、基于动物研究和人类观察的发病机制及获得性免疫的现有知识,以及疫苗开发领域的研究进展。