Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany.
Pathog Dis. 2013 Nov;69(2):127-41. doi: 10.1111/2049-632X.12080. Epub 2013 Sep 10.
The prevalence of autoimmune and allergic disorders has dramatically increased in developed countries, and it is believed that our 'cleaner living' reduces exposure to certain microorganisms and leads to deviated and/or reduced regulation of the immune system. In substantiation of this health hygiene hypothesis, multiple epidemiological studies and animal models have characterized the protective immune responses induced by helminths during auto-inflammatory disorders. The beneficial effects of such helminths, like schistosomes and filariae, are thought to lie in their immunomodulatory capacity, which can be induced by different life-cycle stages or components thereof. In addition to suppressing autoimmunity recent evidence indicates that concurrent helminth infections also counterbalance exacerbated pro-inflammatory immune responses that occur during sepsis, improving survival. As with allergy, epidemiological studies have observed a steady rise in severe sepsis cases and although this may have resulted from several factors (immunosuppressive drugs, chemotherapy, transplantation, increased awareness and increased surgical procedures), it is tempting to hypothesize that the lack of helminth infections in Western countries may have contributed to this phenomenon. This review summarizes how helminths modulate host immunity during sepsis, such as manipulating macrophage activation and provides an overview about the possible implications that may arise during overwhelming bacterial co-infections.
在发达国家，自身免疫和过敏疾病的患病率显著增加，人们认为我们“更清洁的生活”减少了对某些微生物的接触，导致免疫系统的偏离和/或减弱。为了证实这一健康卫生假说，多项流行病学研究和动物模型已经描述了寄生虫在自身炎症性疾病中诱导的保护性免疫反应。像血吸虫和丝虫这样的寄生虫的有益效果被认为在于它们的免疫调节能力，这种能力可以通过不同的生命周期阶段或其成分来诱导。除了抑制自身免疫外，最近的证据表明，同时感染寄生虫也可以抵消败血症期间发生的过度炎症免疫反应，从而提高生存率。与过敏一样，流行病学研究观察到严重败血症病例的稳步增加，尽管这可能是由于多种因素（免疫抑制药物、化疗、移植、意识提高和手术程序增加）所致，但人们不禁假设西方国家缺乏寄生虫感染可能对此现象有所贡献。这篇综述总结了寄生虫如何在败血症期间调节宿主免疫，例如操纵巨噬细胞的激活，并概述了在细菌合并感染时可能出现的影响。
