Helminth infection of humans can perturb immunity and impair vaccine responses. In the Proceedings of the National Academy of Sciences, Yazdanbaksh and colleagues investigate the effect of deworming on immunological parameters in a large cohort of volunteers from rural Indonesia. The study group showed a high incidence (∼90%) of soil-transmitted helminth infection. Treatment with the anti-helminthic agent albendazole every 3 months over 21 months substantially diminished helminth loads but failed to completely eradicate infection. Immunological parameters such as mitogen responses or those to helminth and unrelated malaria parasites measured at 9 and 21 months after treatment resulted in elevated proinflammatory cytokines, especially TNF. The frequency of regulatory T cells (Treg cells) was not affected by the treatment regimen, but there was a significant decrease in the signature inhibitory molecule CTLA-4. This human study of real-world infection demonstrates the reversal of helminth-triggered immune hyporesponsiveness, with potential implications for prophylactic vaccination and the unmasking of autoinflammatory diseases.

Proc. Natl. Acad. Sci. USA (17 October 2016) doi:10.1073/pnas.1604570113