Immune evasion mechanisms of intestinal helminths and their effects on the human host immune response: a literature review
DOI:
https://doi.org/10.70577/asce.v5i4.1137Keywords:
intestinal helminths; immune evasion; immunomodulation; immune response; chronic infectionAbstract
Intestinal helminth infections remain a public health problem in regions with poor sanitation, where chronic infections are associated with anemia, malnutrition, and developmental problems. This study aimed to analyze the immune evasion mechanisms of intestinal helminths and their effects on the human host's immune response. A descriptive-analytical narrative literature review was conducted, with a main search in PubMed using terms related to the analytical categories, complemented with ScienceDirect, SciELO, and documents from the World Health Organization (WHO) and the Pan American Health Organization (PAHO). After applying inclusion and exclusion criteria, 39 sources in Spanish and English, published between 2020 and 2026, were selected. The findings describe three levels of concurrent processes that favor parasite persistence: shifting the immune response toward an attenuated type 2 pattern through excretory/secretory products and dendritic cell reprogramming; active immune suppression through regulatory T and B cells, with a predominance of IL-10, TGF-β, and IgG4; and changes in the gut microbiota, considered an associated condition rather than a directed strategy. These processes are linked to chronic infection, persistent low-grade inflammation, and a shift toward immune tolerance that may reduce responses to coinfections and vaccines. The study concludes that immune evasion involves not only avoiding recognition but also redirecting host signaling, although the evidence comes mainly from nematodes and experimental models. This process can have opposite implications: it is a risk factor in endemic areas and a source of molecules with potential for anti-inflammatory treatment.
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