Current status and future prospects for a vaccine against schistosomiasis

Schistosomiasis remains an intractable problem in many parts of the world. Whereas the schistosome parasites cause little in the way of disease, their eggs become trapped in tissues of the host and elicit powerful and potentially damaging immune responses that are responsible for the pathology. Despite nearly four decades of effort there is still no effective vaccine against schistosomiasis, although a single vaccine candidate is undergoing clinical trials at present. Animal models have revealed much about disease progression and pathology. However, problems remain in identifying appropriate protective antigens to elicit immune responses that will attack the parasite but will not cross-react with egg antigens and thus increase the chance of developing severe chronic disease in individuals that have already been infected. This review summarizes the life-cycle of the parasite, current knowledge of pathogenesis and acquired immunity based on animal studies and observations in humans and the status of efforts in the vaccine development field.