Immune response to Echinococcus infection: parasite avoidance and host protection.

The life cycles of Echinococcus spp, involve two phases that have quite different immunological relationships with the host--the parenteral metacestode and the enteral adult. Immune control of the metacestode (at least of E. granulosus) by vaccination is now a real possibility, but there seems little prospect of similar control of the adult worms. Vaccination against metacestodes must not only induce effective responses but also prevent the parasite modulating these in such a way as to render them ineffective. This requires a much fuller understanding of the basis of parasite avoidance mechanisms, in particular an understanding of the balance of parasite- and host-protective mechanisms that involve the activity of T lymphocyte subsets. Protective responses against adult worms in the intestine appear weak and ineffective, although it is clear that the worms are immunogenic and there is some evidence that the host can become immune. Again, a more complete insight into the nature of the worm's association with the mucosal immune system is required, and a fuller understanding of the variables that influence this association; host genetic variation may prove to be an important factor that determines the outcome of adult worm infections.