Apoptosis as a Potential Target in Therapeutic and Vaccine Interventions against Parasitic Diseases

Apoptosis is a physiological cell death that occurs under normal conditions in major biological processes, including the removal of old, damaged, extra, or harmful cells. It plays an important role in natural evolution, tissue homeostasis, removal of cells damaged or infected by viruses, and removal of immune cells activated against self-antigens. The purpose of this review was to examine the role of apoptosis in parasites and helminths. In this study, four English databases and three Persian databases were used to investigate the articles published between 1999 and 2018. Findings showed that in the Leishmania parasites, Plasmodium and Toxoplasma gondii mimic apoptosis with the expression of phosphatidylserine on the surface of the infected macrophages and prevent the recognition of the infected cell by the host immune system. Also, excreted/secreted antigens in the helminths, including Echinococcus granulosus, Echinococcus multilocularis, and Schistosoma haematobium induce apoptosis in immune cells, especially in lymphocytes. Parasites follow different goals by inducing or preventing apoptosis and current article aimed at reviewing these aspects. Moreover, apoptotic blebs from parasite-infected cell can potentially stimulate the host's immune system, therefore, they could be further investigated in vaccine-related studies.