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Echinococcosis and allergy.

Dominique A Vuitton1

  • 1WHO Collaborating Center for Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, F-25030 Besançon, France. dominique.vuitton@univ-fcomte.fr

Clinical Reviews in Allergy & Immunology
|May 18, 2004
PubMed
Summary

Echinococcosis, a parasitic disease, shares immune links with allergies. Understanding these connections helps develop new treatments for both conditions, highlighting the complex relationship between parasitic and allergic diseases.

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Area of Science:

  • Parasitology
  • Immunology
  • Allergy

Background:

  • Echinococcosis, caused by Echinococcus larvae, presents as cystic echinococcosis (CE) and alveolar echinococcosis (AE).
  • Both CE and AE exhibit strong links with allergic responses due to immune mechanisms that sustain the parasite and can trigger anaphylaxis.
  • Host immune status significantly influences disease presentation, with Th1 responses correlating with protection and Th2 responses with parasite proliferation.

Purpose of the Study:

  • To explore the intricate immunological relationship between echinococcosis and allergic diseases.
  • To identify key Echinococcus allergens and their role in immune responses.
  • To evaluate the evolving therapeutic strategies for echinococcosis, including minimally invasive procedures and immunomodulation.

Main Methods:

  • Analysis of clinical observations and mass screening data from endemic areas.
  • Review of experimental and clinical studies on host immune responses (Th1/Th2, IL-10).
  • Identification and characterization of Echinococcus-specific allergens (AgB, Ag5, EA 21, Eg EF-1 beta/delta).
  • Evaluation of anaphylactic reactions and IgE levels in patients.
  • Assessment of the efficacy of the PAIR (puncture, aspiration, injection, re-aspiration) technique and immunomodulatory therapies.

Main Results:

  • Host genetics and immune profiles (e.g., IL-10 secretion) are linked to echinococcosis occurrence and severity.
  • Anaphylactic reactions are common in CE and rare in AE, often associated with cyst rupture or dissemination.
  • Echinococcus-specific IgE and histamine release from basophils are prevalent in patients, indicating sensitization.
  • Several Echinococcus allergens have been identified, with some showing homology to other allergens and potential for cross-reactivity.
  • The PAIR technique is a viable treatment option for selected CE cases, and immunomodulation (e.g., interferon alpha) shows therapeutic potential.

Conclusions:

  • Echinococcosis and allergic diseases share common immunological features, such as Th2-driven responses and IL-10-mediated tolerance.
  • Understanding these shared immune pathways is crucial for developing novel therapeutic and preventive strategies for both conditions.
  • The study underscores the value of comparative analysis between parasitic and allergic diseases to unravel immune deviation mechanisms.

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