Identifying novel candidates and configurations for human helminth vaccines

INTRODUCTION: : Human infections with helminth worm parasites are extraordinarily prevalent across tropical and subtropical parts of the world, and control relies primarily on drugs that offer short-term suppression of infection. There is an urgent need for new vaccines that would confer long-lived immunity, protecting children in particular and minimizing community transmission. AREAS COVERED: : This article discusses the development of helminth vaccines, from the first successful veterinary vaccines that demonstrated the feasibility of inducing protective immunity to helminths, to more recent initiatives to test human helminth antigens. The field has focussed primarily on evaluating individual antigens that could constitute targets amenable to antibody attack to inhibit parasite establishment. In a new direction, vaccines employing extracellular vesicles released by helminths have also given exciting results. EXPERT OPINION: : Taking into account the complex life cycles and sophisticated immune evasion strategies of many helminths, a combination of antigens and approaches designed to target essential functional pathways of the parasite will be required to achieve a high level of protection in future anti-helminth vaccines.