Immunologic responses to common antigens in helminthic infections and allergic disease.

PURPOSE OF REVIEW: It is estimated that over 1 billion individuals are infected with helminth parasites worldwide. Epidemiologic studies have pointed to a protective role of helminthic infections in the development of allergy and asthma; however, evidence for this inverse association has not been consistently established. The focus of this review is to discuss the potential role of shared antigens between parasites and environmental allergens in modulating allergic immune responses, specifically tropomyosin.

RECENT FINDINGS: Tropomyosin has been identified as a highly conserved molecule in invertebrates. In populations exposed concomitantly to mites, cockroach, Ascaris, and shrimp and other crustaceans and mollusks, IgE antibody responses to tropomyosin are found in over 50% of individuals. Evidence suggests that IgE cross-reactivity to tropomyosin has clinical relevance.

SUMMARY: Mechanisms underlying the immunomodulatory effects of parasites in allergy and asthma remain poorly understood. Identification of molecules in intestinal parasites, particularly Schistosoma mansoni and Ascaris lumbricoides, associated with protection from or promotion of allergy and asthma, could provide the basis for novel forms of treatment or prevention of these diseases. Prospective studies will be necessary to clarify the role of tropomyosin and other parasite antigens shared with inhalant or food allergens in the development of allergic diseases.