INTRODUCTIONParasitic diseases represent a significant burden for health and for socioeconomical development in many tropical countries. The immuno prophylaxy of these infections would be a major advance, and this certainly justifies the important investments made at national and international levels in the search for a vaccine against the major human parasites. It should be stressed, however, that despite remarkable and sometimes spectacular progress, this goal still remains far out of reach. Parasites are, in general, of very ancient lineage; schistosomes for instance evolved from blood flukes during the Permian era, which means that they have had something on the order of 250 million years to perfect survival tactics appropriate to their coexistence with their vertebrate host immune system. For evolutionary reasons, in comparison with other infectious agents, they represent by their structure and the complexity of their life cycle a highly elaborate model of host-parasite interplay. Not surprisingly therefore, when immunologists started to study the immune response to parasites, they discovered that the adaptation of the parasite to its host was the result of a complex, refined, and dynamic balance between host effector mechan isms and parasite escape strategy. At the same time, they were struck by the fact that some entirely novel mechanisms were involved in antiparasite immunity, almost allowing researchers to rewrite some chapters of immunology textbooks. 455 0732-0582/85/0410-0455$02.00' Annu. Rev. Immunol. 1985.3:455-476. Downloaded from www.annualreviews.org Access provided by University of Utah -Marriot Library on 11/29/14. For personal use only. Quick links to online content Further ANNUAL REVIEWS 456 CAPRON & DESSAINTThe purpose of this review is to give an account of the immunology we have learned from parasites. The general message is that the understanding of these mechanisms appears indispensable for possible development of antiparasite vaccines and, more generally, provides new and fascinating insights into many areas of human pathology.Among the parasites used as models, schistosomes probably have been employed in the broadest experimental approach. They have illustrated the existence of novel effector and regulatory mechanisms among the im munological components of the specific response to metazoan parasites.An infection that affects 300 million people in the world, schistosomiasis is characterized by the presence of adult worms in the portal and mesenteric veins of humans and of various other mammalian species, as part of a complex migratory cycle initiated by cutaneous penetration of aquatic infective cercariae. These transform into schistosomula under the skin of appropriate hosts. It is generally agreed that pathological reactions to schistosome infection are related to the deposition of numerous parasite eggs in host tissues (106).
STUDY MODELSAlthough clinical studies have made possible the investigation of several immune mechanisms operating in man (17, 78), most of the information is de...