Humoral immune responses

More than 90% of immunocompetent patients with strongyloidiasis have detectable serum levels of immunoglobulins of the IgG, IgA and IgE classes specifically directed against the antigens of S. stercoralis filariform larvae. The most prominent humoral response directed against S. stercoralis filariform larvae is represented by the IgG4 subclass. More than 50 different antigens, most between 15 and 100 kDa, are recognized by IgG4, while less than 20 antigens are recognized by the other IgG subclasses. A 40 kDa protein identified as zinc endopeptidase and two other unidentified proteins (31 and 28 kDa) are among the antigens that elicit the most consistent and specific responses in infected patients. There is no evidence, however, that any of the circulating antibodies directed against S. stercoralis antigens have a role in protecting the host against dissemination. Many patients without detectable humoral responses against parasite antigens have apparently well-controlled, asymptomatic infections. High titers of parasite-specific antibodies may be found in the serum of immunocompromised patients with disseminated infection. Immunologic studies in primate and canine models of steroid-induced disseminated strongyloidiasis have failed to demonstrate a relationship between humoral responses and the course of the parasitosis. Partial protection against primary infection, however, has been demonstrated in rats actively and passively immunized against .S. ratti larval antigens.

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