The intermediate host immune response in cystic echinococcosis

Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic infection. In most cases, CE cysts and the intermediate host co-habit for a long time in the absence of symptoms and elicit very little inflammation. However, the immune interplay between the parasite and the host is complex, encompassing effective parasite-killing immune mechanisms implemented by the host, which in turn are modulated by the parasite. The immune response to the parasite has been exploited for the diagnosis of the disease and for the development of an effective vaccine to use in the natural intermediate host, but the mechanisms of parasite killing and immunomodulation are still unknown. Here, we reviewed the immune effector mechanisms and the strategies of immune evasion in the intermediate host.