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      Helminth Immunomodulation in Autoimmune Disease

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          Abstract

          Helminths have evolved to become experts at subverting immune surveillance. Through potent and persistent immune tempering, helminths can remain undetected in human tissues for decades. Redirecting the immunomodulating “talents” of helminths to treat inflammatory human diseases is receiving intensive interest. Here, we review therapies using live parasitic worms, worm secretions, and worm-derived synthetic molecules to treat autoimmune disease. We review helminth therapy in both mouse models and clinical trials and discuss what is known on mechanisms of action. We also highlight current progress in characterizing promising new immunomodulatory molecules found in excretory/secretory products of helminths and their potential use as immunotherapies for acute and chronic inflammatory diseases.

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          Most cited references162

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          Chemically induced mouse models of intestinal inflammation.

          Animal models of intestinal inflammation are indispensable for our understanding of the pathogenesis of Crohn disease and ulcerative colitis, the two major forms of inflammatory bowel disease in humans. Here, we provide protocols for establishing murine 2,4,6-trinitro benzene sulfonic acid (TNBS)-, oxazolone- and both acute and chronic dextran sodium sulfate (DSS) colitis, the most widely used chemically induced models of intestinal inflammation. In the former two models, colitis is induced by intrarectal administration of the covalently reactive reagents TNBS/oxazolone, which are believed to induce a T-cell-mediated response against hapten-modified autologous proteins/luminal antigens. In the DSS model, mice are subjected several days to drinking water supplemented with DSS, which seems to be directly toxic to colonic epithelial cells of the basal crypts. The procedures for the hapten models of colitis and acute DSS colitis can be accomplished in about 2 weeks but the protocol for chronic DSS colitis takes about 2 months.
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            Immune regulation by helminth parasites: cellular and molecular mechanisms.

            Immunology was founded by studying the body's response to infectious microorganisms, and yet microbial prokaryotes only tell half the story of the immune system. Eukaryotic pathogens--protozoa, helminths, fungi and ectoparasites--have all been powerful selective forces for immune evolution. Often, as with lethal protozoal parasites, the focus has been on acute infections and the inflammatory responses they evoke. Long-lived parasites such as the helminths, however, are more remarkable for their ability to downregulate host immunity, protecting themselves from elimination and minimizing severe pathology in the host.
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              T cell antigen receptor recognition of antigen-presenting molecules.

              The Major Histocompatibility Complex (MHC) locus encodes classical MHC class I and MHC class II molecules and nonclassical MHC-I molecules. The architecture of these molecules is ideally suited to capture and present an array of peptide antigens (Ags). In addition, the CD1 family members and MR1 are MHC class I-like molecules that bind lipid-based Ags and vitamin B precursors, respectively. These Ag-bound molecules are subsequently recognized by T cell antigen receptors (TCRs) expressed on the surface of T lymphocytes. Structural and associated functional studies have been highly informative in providing insight into these interactions, which are crucial to immunity, and how they can lead to aberrant T cell reactivity. Investigators have determined over thirty unique TCR-peptide-MHC-I complex structures and twenty unique TCR-peptide-MHC-II complex structures. These investigations have shown a broad consensus in docking geometry and provided insight into MHC restriction. Structural studies on TCR-mediated recognition of lipid and metabolite Ags have been mostly confined to TCRs from innate-like natural killer T cells and mucosal-associated invariant T cells, respectively. These studies revealed clear differences between TCR-lipid-CD1, TCR-metabolite-MR1, and TCR-peptide-MHC recognition. Accordingly, TCRs show remarkable structural and biological versatility in engaging different classes of Ag that are presented by polymorphic and monomorphic Ag-presenting molecules of the immune system.
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                Author and article information

                Contributors
                Journal
                Front Immunol
                Front Immunol
                Front. Immunol.
                Frontiers in Immunology
                Frontiers Media S.A.
                1664-3224
                24 April 2017
                2017
                : 8
                : 453
                Affiliations
                [1] 1School of Biomedical Sciences, The University of Queensland , Brisbane, QLD, Australia
                [2] 2Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University , Cairns, QLD, Australia
                [3] 3QIMR Berghofer Medical Research Institute , Brisbane, QLD, Australia
                [4] 4Division of Infection and Immunity, Cardiff University School of Medicine , Cardiff, UK
                [5] 5School of Medicine, The University of Queensland , Brisbane, QLD, Australia
                Author notes

                Edited by: Anne Cooke, University of Cambridge, UK

                Reviewed by: Henry Mcsorley, University of Edinburgh, UK; Nathan Karin, Technion – Israel Institute of Technology, Israel

                *Correspondence: John J. Miles, john.miles@ 123456jcu.edu.au

                These authors have contributed equally to this work.

                Specialty section: This article was submitted to Immunological Tolerance and Regulation, a section of the journal Frontiers in Immunology

                Article
                10.3389/fimmu.2017.00453
                5401880
                28484453
                8cc3c696-d000-4dfc-93cc-eda25fbd338e
                Copyright © 2017 Smallwood, Giacomin, Loukas, Mulvenna, Clark and Miles.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 January 2017
                : 03 April 2017
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 188, Pages: 15, Words: 13099
                Funding
                Funded by: Australian Research Council 10.13039/501100000923
                Award ID: FT100100476
                Funded by: National Cancer Institute 10.13039/100000054
                Award ID: R01CA155297
                Funded by: National Health and Medical Research Council 10.13039/501100000925
                Award ID: 1117505, 1031652, 1051627
                Categories
                Immunology
                Review

                Immunology
                helminthic therapy,autoimmunity,immunomodulation,excretory/secretory products,immunotherapy

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