Trinity Biomedical Sciences Institute, School of Medicine, Trinity College Dublin Dublin, Ireland ; National Children's Research Centre, Our Lady's Children's Hospital Dublin, Ireland.
Front Immunol. 2013 Apr 15;4:89. doi: 10.3389/fimmu.2013.00089. eCollection 2013.
Infection of man with Schistosoma species of trematode parasite causes marked chronic morbidity. Individuals that become infected with Schistosomes may develop a spectrum of pathology ranging from mild cercarial dermatitis to severe tissue inflammation, in particular within the liver and intestines, which can lead to life threatening hepatosplenomegaly. It is well established that the etiopathology during schistosomiasis is primarily due to an excessive or unregulated inflammatory response to the parasite, in particular to eggs that become trapped in various tissue. The eggs forms the foci of a classical type 2 granulomatous inflammation, characterized by an eosinophil-rich, CD4(+) T helper (Th) 2 cell dominated infiltrate with additional infiltration of alternatively activated macrophages (M2). Indeed the sequela of the type 2 perioval granuloma is marked fibroblast infiltration and development of fibrosis. Paradoxically, while the granuloma is the cause of pathology it also can afford some protection, whereby the granuloma minimizes collateral tissue damage in the liver and intestines. Furthermore, the parasite is exquisitely reliant on the host to mount a granulomatous reaction to the eggs as this inflammatory response facilitates the successful excretion of the eggs from the host. In this focused review we will address the conundrum of the S. mansoni granuloma acting as both friend and foe in inflammation during infection.
曼氏血吸虫等吸虫寄生虫感染人体会导致明显的慢性发病。感染血吸虫的个体可能会发展出一系列的病理学变化，从轻微的尾蚴性皮炎到严重的组织炎症，特别是在肝脏和肠道内，这可能导致危及生命的肝脾肿大。已经证实，血吸虫病的病因主要是对寄生虫的过度或失调的炎症反应，特别是对被困在各种组织中的虫卵的反应。这些虫卵形成了典型的 2 型肉芽肿炎症的焦点，其特征是富含嗜酸性粒细胞、CD4+T 辅助（Th）2 细胞占主导地位的浸润，并有替代性激活的巨噬细胞（M2）的额外浸润。事实上，2 型周围卵球肉芽肿的后遗症是明显的成纤维细胞浸润和纤维化的发展。矛盾的是，虽然肉芽肿是导致病理学的原因，但它也可以提供一些保护，通过肉芽肿使肝脏和肠道的继发组织损伤最小化。此外，寄生虫非常依赖宿主对虫卵产生肉芽肿反应，因为这种炎症反应有助于虫卵从宿主中成功排出。在本专题综述中，我们将探讨曼氏血吸虫肉芽肿在感染期间作为炎症的朋友和敌人的双重作用这一难题。
