The worm turns

Coinfection in mice with Schistosoma mansoni reduces mortality induced by Toxocari canis and prevents Plasmodium-associated brain lesions and, on the contrary, promotes replication of Leishmania and enhances susceptibility to tuberculosis. Such interactions are diifuclt to appraise with the reductionist approach of “Koch’s postulates”, that were coined to determine when a particular organism could be held responsible for a particular disease state. The outcome of infection with a given organism does not always equate to disease. Besides the genetic background, intersecting influences of coinfecting organisms (from symbiotic microflora to virulent pathogens) affect the outcome of infection. And, because of their effects orchestrating host immunoregulation and chronic infections, helmiths provide examples of the potential of co-infections to alter diagnosis, course and outcome of disease processes. This paper decribes how helminths infections immunoregulate imflammatory responses and autoimmune reactions, as well as how they modulate pathogenicity, course and outcome to concurrent infection with other pathogens.

The Worm Turns: Trematodes Steering the Course of Co-infections. Vet Pathol 2014 51:328-340

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