1 Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK. 2 MRC Centre for Inflammation Research, University of Edinburgh, Queens Medical Research Institute, Edinburgh, UK. 3 Address correspondence to: Rick M. Maizels, Institute of Immunology and Infection Research, University of Edinburgh, West Mains Road, Edinburgh, EH9 3JT, UK.
Transplantation. 2014 Jan 27;97(2):127-32. doi: 10.1097/TP.0b013e3182a53f59.
Current immunosuppression regimens for solid-organ transplantation have shown disappointing efficacy in the prevention of chronic allograft rejection and carry unacceptable risks including toxicity, neoplasia, and life-threatening infection. Achievement of immunological tolerance (long-term antigen unresponsiveness in an immunocompetent host) presents the exciting prospect of freedom from immunosuppression for transplant recipients. It is now 60 years since the first demonstration of immunological tolerance in animal models of transplantation, but translation into routine clinical practice remains elusive. Helminth parasites may provide novel strategies toward achieving this goal. Helminths are remarkably successful parasites: they currently infect more than one quarter of the world's population. It is now well established that the parasites' success is the result of active immunomodulation of their hosts' immune response. Although this primarily secures ongoing survival of the parasites, helminth-induced immunomodulation can also have a number of benefits for the host. Significant reductions in the prevalence of allergy and autoimmune conditions among helminth-infected populations are well recognized and there is now a significant body of evidence to suggest that harmful immune responses to alloantigens may be abrogated as well. Here, we review all existing studies of helminth infection and transplantation, explore the mechanisms involved, and discuss possible avenues for future translation to clinical practice.
目前，实体器官移植的免疫抑制方案在预防慢性移植物排斥方面效果不佳，且存在不可接受的风险，包括毒性、肿瘤形成和威胁生命的感染。免疫耐受（免疫宿主的长期抗原无反应性）的实现为移植受者带来了摆脱免疫抑制的令人兴奋的前景。自首次在移植动物模型中证明免疫耐受以来，已经过去了 60 年，但将其转化为常规临床实践仍然难以实现。寄生虫可能为实现这一目标提供新的策略。寄生虫是非常成功的寄生虫：它们目前感染了世界上超过四分之一的人口。现在已经确定，寄生虫的成功是其宿主免疫反应的主动免疫调节的结果。尽管这主要确保了寄生虫的持续生存，但寄生虫诱导的免疫调节也可以为宿主带来许多益处。在寄生虫感染人群中，过敏和自身免疫性疾病的患病率显著降低，现在有大量证据表明，同种异体抗原的有害免疫反应也可能被消除。在这里，我们回顾了所有现有的寄生虫感染和移植研究，探讨了所涉及的机制，并讨论了未来转化为临床实践的可能途径。
