Bhengu Khethiwe Nomcebo, Naidoo Pragalathan, Singh Ravesh, Mpaka-Mbatha Miranda N, Nembe Nomzamo, Duma Zamathombeni, Pillay Roxanne, Mkhize-Kwitshana Zilungile L
Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban 4001, South Africa.
Division of Research Capacity Development, South African Medical Research Council (SAMRC), Cape Town 7505, South Africa.
Diagnostics (Basel). 2022 Nov 4;12(11):2676. doi: 10.3390/diagnostics12112676.
Helminth infections are among the neglected tropical diseases affecting billions of people globally, predominantly in developing countries. Helminths' effects are augmented by coincident tuberculosis disease, which infects a third of the world's population. The role of helminth infections on the pathogenesis and pathology of active tuberculosis (T.B.) remains controversial. Parasite-induced suppression of the efficacy of Bacille Calmette-Guerin (BCG) has been widely reported in helminth-endemic areas worldwide. T.B. immune response is predominantly proinflammatory T-helper type 1 (Th1)-dependent. On the other hand, helminth infections induce an opposing anti-inflammatory Th2 and Th3 immune-regulatory response. This review summarizes the literature focusing on host immune response profiles during single-helminth, T.B. and dual infections. It also aims to necessitate investigations into the complexity of immunity in helminth/T.B. coinfected patients since the research data are limited and contradictory. Helminths overlap geographically with T.B., particularly in Sub-Saharan Africa. Each disease elicits a response which may skew the immune responses. However, these effects are helminth species-dependent, where some parasites have no impact on the immune responses to concurrent T.B. The implications for the complex immunological interactions that occur during coinfection are highlighted to inform government treatment policies and encourage the development of high-efficacy T.B. vaccines in areas where helminths are prevalent.
蠕虫感染属于被忽视的热带病，全球数十亿人受其影响，主要集中在发展中国家。蠕虫感染的影响因同时存在的结核病而加剧，结核病感染了全球三分之一的人口。蠕虫感染在活动性结核病发病机制和病理过程中的作用仍存在争议。在全球蠕虫流行地区，寄生虫导致卡介苗（BCG）效力受抑制的情况已被广泛报道。结核病免疫反应主要依赖促炎的1型辅助性T细胞（Th1）。另一方面，蠕虫感染会引发相反的抗炎性Th2和Th3免疫调节反应。本综述总结了聚焦于单一蠕虫感染、结核病感染及双重感染期间宿主免疫反应特征的文献。鉴于研究数据有限且相互矛盾，其目的还在于促使对蠕虫/结核病合并感染患者免疫复杂性展开调查。蠕虫在地理分布上与结核病重叠，尤其是在撒哈拉以南非洲地区。每种疾病都会引发一种可能使免疫反应发生偏差的反应。然而，这些影响取决于蠕虫种类，有些寄生虫对同时发生的结核病免疫反应没有影响。文中强调了合并感染期间发生的复杂免疫相互作用的影响，以为政府治疗政策提供参考，并鼓励在蠕虫流行地区研发高效的结核病疫苗。
