“
“Hookworms are one of the most

prevalent parasites of humans in developing countries, but we know relatively little about the immune response generated to hookworm infection. This can be attributed to a lack of permissive animal models and a relatively small research community compared with those of the more high-profile parasitic diseases. However, recently, research has emerged on the development of vaccines to control hookworm infection and the use of hookworm to treat autoimmune and allergic disorders, contributing to a greater understanding of the strategies used by hookworms to modulate the host’s immune response. A substantial body of research on the immunobiology of hookworms originates from Australia, so this review will summarize the current status of the field with a particular emphasis on research carried out ‘down under’. Ku-0059436 in vivo Hookworms are one of the most common

parasites of humans, with around 740 million people infected worldwide. Although they cause little mortality, heavy infections can cause iron-deficiency anaemia, growth retardation and low birth weight (1). Hookworms are most prevalent in South America, sub-Saharan Africa and East Asia; however, up until the second half of the 20th century, they were also common in the southern states of USA, Europe (2) and Australia, where they still affect some remote aboriginal communities (3). The two major anthropophilic hookworm species are Necator americanus Luminespib in vivo and Ancylostoma duodenale. The more common parasite, on which the majority of studies have consequently been carried out, is N. americanus. Hookworms are soil-transmitted helminths: infective larvae burrow through the skin and are activated in the process, after which they migrate through the heart and lungs to the gut, where they mature to adults, feed on host blood and produce eggs which are deposited in the faeces. Deposited eggs then develop to infective larvae, completing the life cycle (1). The host Isotretinoin must therefore mount an immune response against a number of different parasite

stages during a hookworm infection, and the parasite in turn has a number of opportunities to manipulate the host immune system. We will not dwell on the life cycle of the parasite in this review – for more detail, see (4). The immunology of human hookworm infection has not received as much focus as that of other helminth parasites of humans, such as schistosomes and filariae. The reasons for this include the relatively low mortality caused by hookworms, the difficulty/expense in maintaining the life cycle in a suitable animal model and the inability of any of the major species of hookworms to reach maturity in mice. This has especially been a problem in Australia where the best laboratory model, the hamster, is not permitted to be maintained in the country because of quarantine regulations. Consequently, Australian hookworm research has focussed on human immunology, and especially experimental or zoonotic human infections.