Is tumour necrosis factor alpha the molecular basis of concomitant immunity in schistosomiasis?

Prior to the development of high levels of resistance to infection with schistosomes, some mechanism appears to limit the number of productive worms in individuals, since children do not become superinfected, despite continued exposure to infection. One way in which infection levels might be limited, is through the generation of a concomitant immunity. Concomitant immunity results in the destruction of newly invading schistosomula whilst established adult worms continue to survive. Recent studies have provided evidence that TNF alpha enhances worm fecundity and is essential for granuloma formation. TNF alpha may therefore be important in worm reproduction and transmission, since the granuloma may serve to assist the passage of the eggs out of the tissues. With the additional evidence that the cytotoxic activity of lymphokine-activated macrophages against schistosomula may be, at least in part, due to the action of TNF alpha, we propose that TNF alpha may also be responsible for the phenomenon of concomitant immunity.