Wang Meng, Wu Linxiang, Weng Rennan, Zheng Weihong, Wu Zhongdao, Lv Zhiyue
Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080, China.
Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080, China.
Parasitol Res. 2017 Aug;116(8):2065-2074. doi: 10.1007/s00436-017-5544-5. Epub 2017 Jun 29.
Helminths have accompanied human throughout history by releasing immune-evasion molecules that could counteract an aberrant immune response within the host. In the past decades, helminth infections are becoming less prevalent possibly due to the developed sanitation. Meanwhile, the incidence of autoimmune diseases is increasing, which cannot be exclusively explained by the changes of susceptibility genes. While the hygiene hypothesis casts light on the problem. The infections of helminths are believed to interact with and regulate human immunity with the byproduct of suppressing the autoimmune diseases. Thus, helminths are potential to treat or cure the autoimmune diseases. The therapeutic progresses and possible immune suppression mechanisms are illustrated in the review. The helminths that are studied most intensively include Heligmosomoides polygyrus, Hymenolepis diminuta, Schistosoma mansoni, Trichinella spiralis, and Trichuris suis. Special attentions are paid on the booming animal models and clinical trials that are to detect the efficiency of immune-modulating helminth-derived molecules on autoimmune diseases. These trials provide us with a prosperous clinical perspective, but the precise mechanism of the down-regulatory immune response remains to be clarified. More efforts are needed to be dedicated until these parasite-derived immune modulators could be used in clinic to treat or cure the autoimmune diseases under a standard management.
蠕虫在整个人类历史中一直伴随着人类,它们释放免疫逃避分子,这些分子可以抵消宿主体内异常的免疫反应。在过去几十年中,由于卫生条件的改善,蠕虫感染的发生率可能正在降低。与此同时,自身免疫性疾病的发病率正在上升,这不能完全用易感基因的变化来解释。卫生假说为这个问题提供了线索。人们认为蠕虫感染通过抑制自身免疫性疾病的副产品来与人类免疫系统相互作用并进行调节。因此,蠕虫具有治疗或治愈自身免疫性疾病的潜力。本综述阐述了治疗进展和可能的免疫抑制机制。研究最深入的蠕虫包括多枝海德线虫、微小膜壳绦虫、曼氏血吸虫、旋毛虫和猪鞭虫。特别关注正在兴起的动物模型和临床试验,这些试验旨在检测免疫调节性蠕虫衍生分子对自身免疫性疾病的疗效。这些试验为我们提供了一个充满希望的临床前景,但下调免疫反应的确切机制仍有待阐明。在这些寄生虫衍生的免疫调节剂能够在标准管理下用于临床治疗或治愈自身免疫性疾病之前,还需要付出更多努力。