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Abstract
There has been a negative association between certain parasite infections at an early age and allergic diseases based on the epidemiological data. Parasitic helminths excrete or secrete products/allergens which develop Th2 responses to increase IgE production and to induce CD4+ T cells. Cytokines such as IL-4, IL-5, IL-9 and IL-13 are produced in parasite infections as similar as in various allergic diseases. The immune responses against helminth infections may cause pathologic effects, and provoke allergic manifestations. However, human hosts use the hypersensitivity response to protect themselves against helminth infection. Meanwhile, the intradermal test would have been used for diagnosis of fluke infections in Korea to take advantage of the hypersensitivity reaction. Chronic infections with parasites in turn induce forms of immune suppression or down regulation. FoxP3+CD4+ Treg cells, alternatively activated macrophages, CD4+ Tr1 secreting IL-10 and TGF-β, and Th3 cells take part in immunosuppressive regulatory responses. Immunoregulation is likely to play a major part in parasite strategies for survival in a sensitized host. Helminth infections accompanied with immune modulation may protect not only from Th2 inflammation (allergies) but also from Th1 inflammation. CD4+CD25+ FoxP3+ T cells play a major role of modulating experimental allergic asthma upon helminth antigen challenges, which is independent of IL-10. Regulatory B cells also can prevent or reverse allergen-induced airway inflammation via an IL-10 mediated mechanism and Treg cells. More researches are necessary to identify parasite derived molecules for the development of new therapeutics to combat allergies and other diseases caused by inappropriate immune responses.
Figures and Tables
Fig. 1
Helminth infections and allergic responses. Th2 polarization is a characteristic phenomenon of acute helminth infections. Helminthic infections, however, tend to be chronic. A parasite-induced immunomodulation is helpful to sustain parasites in the host, and may have a down-regulatory effect on allergic responses.
DCreg: regulatory dendritic cells, DC2: type 2 dendritic cells, Treg: CD4+CD25+ FoxP3+ regulatory T cells, aaM: alternatively activated macrophage, Breg: regulatory B cells
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