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Parasite Immunology and the clinical immunologist

Parasites of man are at last beginning to receive some of the attention that they deserve as major causes of mortality among the population of the poorest countries of the world. Whether the renewed interest of the wealthy countries in parasitic infections results from compassion or from a realization that poor countries are poor markets for their exports can be debated but, whatever the cause, it is happening. The tragedy of AIDS, which has highlighted the desperate situation of many countries in sub-Saharan Africa, has probably also played a role in this process. Among the parasitic diseases, malaria is receiving the most attention. Two years ago, the World Health Organization launched a major new partnership, Roll Back Malaria, which has set ambitious targets for improvements in malaria control. Several established donors, such as the National Institutes of Health, have increased their support for malaria research and new donors, including the Gates Foundation, have entered the field. Filariasis is targeted for global elimination through a public±private partnership that will use chemotherapy with ivermectin and albendazole to control the infection. Even orphan parasitic infections, such as African trypanosomiasis, are receiving a little more attention than in the past. Much of this renewed activity will be directed at the development of new drugs and vaccines and their evaluation in the field. However, it will also open up many new opportunities for clinical immunologists interested in parasitic infections. For several parasitic infections, surveillance of the prevalence of infection before and after the introduction of control measures can be performed most economically using sero-diagnostic tests and more work is needed in this area. The ways in which immunity and chemotherapy can enhance each other's efficacy in eliminating parasites has been shown in several infections, including schistosomiasis, but has generally received little attention from immunologists. Adverse effects of treatment of parasitic infections frequently have an immunological basis but little work has been carried out in this area. Finally, immunologists have a critical role to play in vaccine studies through an investigation of possible immunological correlates of protection. Parasite Immunology has always welcomed papers that describe studies of the immune response of man to parasite infections but, in recent years, the journal has been widely perceived as one interested primarily in animal studies. As more opportunities arise for the study of the immune response to human parasite infections, the Editors of Parasite Immunology hope that more high quality papers describing immunological studies of parasitic infection in man will reach their desks.