Abstract
Trematodes of the genus Schistosoma reside in the bloodstream of their definitive vertebrate hosts, where they avoid immune destruction and survive for years or decades. Widespread species such as S. mansoni and S. japonicum remain important causes of intestinal and hepatic schistosomiasis in humans throughout South America, Africa and Asia, while S. haematobium, the causative agent of human urinary schistosomiasis, remains prevalent in many areas of Africa. Other species, such as S. bovis and S. mattheei, are of considerable veterinary concern. Despite their continued presence at intravascular locations for periods of years, the adult parasites themselves provoke remarkably little tissue damage or inflammation. In contrast, the eggs produced by adult schistosomes can cause considerable tissue damage and stimulate intense inflammatory and immune reactions. Indeed, the clinical classification of schistosomiasis as hepatic, intestinal or urinary depends on which organ or system is most severely affected by parasite eggs. Frequently over 100 μm long and possessing a tough proteinaceous shell, schistosome eggs trapped in host tissues such as the liver are not readily eliminated. Consequently, like other focal stimuli of chronic inflammation, parasite eggs become the focus of granulomatous inflammatory reactions known as granulomas. Persistence of eggs and the granulomas that surround them results in fibroblast activation, synthesis of extracellular matrix proteins, formation of intractable fibrotic scars and disruption of tissue architecture, ultimately leading to organ dysfunction and the clinical manifestations of schistosomiasis. In this chapter, we review the current understanding of the molecular mechanisms that drive granuloma formation in schistosomiasis. Experimental S. mansoni infections in the laboratory mouse closely resemble those observed in humans, both pathologically and immunologically, and provide an extremely malleable and useful model of the human disease. We will therefore pay particular attention to the latest insights obtained using this murine model of schistosome infection.
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Davies, S.J., McKerrow, J.H. (2000). Molecular Mechanisms of Granuloma Formation in Schistosomiasis. In: Tschudi, C., Pearce, E.J. (eds) Biology of Parasitism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-4622-8_12
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