Acta Trop. 2026 Oct 6:108362. doi: 10.1016/j.actatropica.2026.108362. Online ahead of print.
ABSTRACT
A compelling and paradoxical body of evidence challenges the traditional view of parasites solely as pathogens. This narrative review synthesizes a growing literature suggesting that specific, chronic parasitic infections-particularly by helminths, but also certain protozoa-can, under precise ecological conditions, confer a spectrum of protective and ameliorative effects on the host. We comprehensively detail these effects across two interconnected domains. First, we examine organ-specific immunomodulation, focusing on the attenuation of inflammatory and autoimmune pathologies within the cardiovascular, neuroinflammatory, renal, hepatic, and pulmonary systems. Second, we explore systemic physiological modulations that extend beyond classic immunology, including enhanced tissue repair, improved metabolic homeostasis, neuroprotection, anti-tumor activity, and the engineering of a health-promoting gut microbiome. Underpinning these benefits are shared mechanistic pillars: the induction of regulatory T cells (Tregs) and anti-inflammatory cytokines (IL-10, TGF-β), polarization of macrophages toward an M2 reparative phenotype, and profound remodeling of the gut microbiota. Crucially, we emphasize that these "benefits" are incidental by-products of host-parasite co-evolution, observed only in contexts of low-burden, chronic infection with particular species, and are vastly outweighed by the direct morbidity of active parasitosis. The true translational promise lies in parasite-inspired pharmacology: the identification, synthesis, and therapeutic application of discrete parasite-derived molecules to treat inflammatory, metabolic, degenerative, and neoplastic diseases, offering a novel paradigm for drug discovery inspired by nature's most adept manipulators of host biology.
PMID:42838406 | DOI:10.1016/j.actatropica.2026.108362