Control of schistosomiasis pathology by combination of Sm28GST DNA immunization and praziquantel treatment.

Today the control of schistosomiasis infection relies only on the use of praziquantel (PZQ) chemotherapy. However, PZQ treatment cannot prevent reinfection and progressive development of the pathology. We assessed in a mouse model the efficiency of a combined therapy, based on the combination of PZQ chemotherapy with Schistosoma mansoni 28-kDa glutathion S-transferase (Sm28GST) DNA vaccination, designed to limit the pathology. Following this combined therapy, the long-term survival of the mice was significantly enhanced in comparison with the survival of mice either vaccinated only or treated with PZQ only. In addition, the development of the pathology observed in the control groups was almost completely prevented in the vaccinated-PZQ-treated mice and was associated with a dramatic reduction of egg deposition in the tissues. We showed that PZQ treatment induced the unmasking of the native GST enzyme at the surface of the worms, thus permitting its neutralization by the antibodies raised by DNA immunization. This study provides insights into the synergistic mechanisms involved in an immunointervention strategy associated with chemotherapy for the control of a chronic infection and its associated pathology.