Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 28, 2017; 9(30): 1176-1189
Published online Oct 28, 2017. doi: 10.4254/wjh.v9.i30.1176
Liver cystic echinococcosis and human host immune and autoimmune follow-up: A review
Nikica M Grubor, Katica D Jovanova-Nesic, Yehuda Shoenfeld
Nikica M Grubor, Department of Hepatobiliary and Pancreatic Surgery, First Surgical University Hospital, Clinical Center of Serbia, School of Medicine University of Belgrade, 11000 Belgrade, Serbia
Katica D Jovanova-Nesic, Immunology Research Center, Institute of Virology, Vaccine and Sera-Torlak, 11221 Belgrade, Serbia
Katica D Jovanova-Nesic, European Center for Peace and Development, University for Peace in the United Nation established in Belgrade, 11000 Belgrade, Serbia
Yehuda Shoenfeld, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Aviv University, 5265601 Tel-Hashomer, Tel Aviv, Israel
Author contributions: All the authors reviewed the literature and wrote the manuscript; Shoenfeld Y edited the paper.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Katica D Jovanova-Nesic, PhD, Immunology Research Center, Institute of Virology, Vaccine and Sera-Torlak, Vojvode Stepe 458, 11221 Belgrade, Serbia.
Telephone: +381-11-3948381 Fax: +381-11-3234082
Received: March 25, 2017
Peer-review started: March 28, 2017
First decision: June 30, 2017
Revised: August 28, 2017
Accepted: September 14, 2017
Article in press: September 15, 2017
Published online: October 28, 2017
Core Tip

Core tip: The most common location of a hydatid echinococcal cyst is in the liver. The survival of Echinococcus within host tissues, despite the development of specific antibodies, is possible due to specific immunomodulation induced by parasites. Perpetual survival of parasites indicating multi-level systematic evasion against host protective reaction to persist their growth and spreading. Complement modulation, a metabolic adaptation to the host microenvironment, plentiful thermostable immunogenic antigen B in the cystic fluid, and induction of CD4+CD8+FOXP3+ T cells allows the persistence of the parasites. Parasites influence dendritic cell (DC) maturation and impair activation by toll-like receptor. It seems that DC-parasite interaction is pivotal in triggering and regulating parasite induced immunity.