Evasive strategies by the organism

Anything written on evasion strategies in nematodi-ases remains speculative. The parasite alters its surface and secreted antigens during its tissue migrations, and it has been suggested that this functions to keep the parasite ahead of the immune response. This would not, however, be compatible with the continuous recruitment of parasites known to occur in infected humans. The larvae secrete proteinases which could cleave bound antibody and/or complement. Parasitic nematodes commonly secrete antioxidants, such as superoxide dismutase, but this has not been examined for Ascaris. If, like the related nematode Toxocara canis, Ascaris has a surface that rapidly sheds antigens, then continuous loss of bound antibody, complement and/or cells would provide an immune evasion mechanism. It also might simply be that it is not possible for the immune system to deal with a rapidly migrating multicellular parasite. The intestinal stage of Ascaris is thought to live for at least 1 year, and there appear to be successive waves of recruitment. It is not known how these worms evade the immune response, although it is known from experimental models that some species of gastrointestinal nematodes are able to suppress local and sometimes systemic immune responses. Another possibility is that T cell tolerance to these long-term occupants of the gut is generated.

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