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Journal of Biomedicine and Biotechnology
Volume 2010 (2010), Article ID 923193, 14 pages
http://dx.doi.org/10.1155/2010/923193
Review Article

Echinococcus multilocularis and Its Intermediate Host: A Model of Parasite-Host Interplay

1WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis, CHU de Besançon and Université de Franche-Comté, Place Saint Jacques, 25030 Besançon, France
2Institute of Parasitology, University of Bern, Länggasstrasse 122, CH-3012 Bern, Switzerland

Received 21 September 2009; Accepted 7 January 2010

Academic Editor: Jorge Morales-Montor

Copyright © 2010 Dominique Angèle Vuitton and Bruno Gottstein. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Host-parasite interactions in the E. multilocularis-intermediate host model depend on a subtle balance between cellular immunity, which is responsible for host's resistance towards the metacestode, the larval stage of the parasite, and tolerance induction and maintenance. The pathological features of alveolar echinococcosis. the disease caused by E. multilocularis, are related both to parasitic growth and to host's immune response, leading to fibrosis and necrosis, The disease spectrum is clearly dependent on the genetic background of the host as well as on acquired disturbances of Th1-related immunity. The laminated layer of the metacestode, and especially its carbohydrate components, plays a major role in tolerance induction. Th2-type and anti-inflammatory cytokines, IL-10 and TGF- 𝛽 , as well as nitric oxide, are involved in the maintenance of tolerance and partial inhibition of cytotoxic mechanisms. Results of studies in the experimental mouse model and in patients suggest that immune modulation with cytokines, such as interferon- 𝛼 , or with specific antigens could be used in the future to treat patients with alveolar echinococcosis and/or to prevent this very severe parasitic disease.