Strongyloides stercoralis: Immunobiological considerations on an unusual worm

In the highly competitive world of parasites, where survival is indissolubly tied to the presence of suitable hosts in the same ecological niche, Strongyloides stercoralis occupies a unique position. This versatile nematode has developed a successful relationship with two ecosystems, the terrestrial environment and the mammalian body, by becoming facultatively independent of either (Box 1). It requires external maturation for transmission, but it also has the ability to multiply within a single host. It prefers man, but may infect apes, monkeys, dogs and cats. As a human parasite, S. stercoralis establishes self-perpetuating intestinal colonies and negotiates their survival with the host's defense mechanisms. In this article, Robert Genta reviews the immunobiological aspects of this unusual relationship.