Immunology of cystic echinococcosis (hydatid disease)

Abstract

Background

The neglected disease cystic echinococcosis is caused by larval Echinococcus granulosus flatworms, which form bladder-like hydatid cysts in liver, lungs, and other organs.

Sources of data

Published literature.

Areas of agreement

Establishing larvae are susceptible to antibody-dependent killing, as attested by successful animal vaccination, whereas once established they are partially protected by the so-called laminated layer. Host responses are Th2 dominated, with a Th1 component. Diagnostic antigens from cyst fluid are known, but responses appear absent in one-fifth of patients.

Areas of controversy

Is evasion mainly based on induction of Th2 or regulatory responses by the parasite?

Growing points

The parasite induces regulatory responses. The laminated layer has immune-regulatory properties.

Areas timely for developing research

Develop tools for functional genomics; characterize immunologically interesting proteins suggested by genomic information; analyse infection in broader context of granulomatous responses; identify molecules secreted/excreted by intact larvae/cysts towards their outside, including diffusible immune-regulators.

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