Helminths protect against type 1 diabetes: effects and mechanisms

Parasitol Res. 2019 Apr;118(4):1087-1094. doi: 10.1007/s00436-019-06247-4. Epub 2019 Feb 13.


Type 1 diabetes (T1D) is an autoimmune disease in which cells of the immune system destroy pancreatic β cells, which secrete insulin. The high prevalence of T1D in developed societies may be explained by environmental changes, including lower exposure to helminths. Indeed, infection by helminths such as Schistosoma, Filaria, and Heligmosomoides polygyrus and their by-products has been reported to ameliorate or prevent the development of T1D in human and animal models. Helminths can trigger distinct immune regulatory pathways, often involving adaptive immune cells that include T helper 2 (Th2) cells and regulatory T cells (Tregs) and innate immune cells that include dendritic cells, macrophages, and invariant natural killer T cells, which may act synergistically to induce Tregs in a Toll-like receptor-dependent manner. Cytokines such as interleukin (IL)-4, IL-10, and transforming growth factor (TGF)-β also play an important role in protection from T1D. Herein, we provide a comprehensive review of the effects and mechanisms underlying protection against T1D by helminths.

Keywords: Helminths; Regulatory T cells; Th2; Type 1 diabetes.

Publication types

  • Review

MeSH terms

  • Animals
  • Dendritic Cells / immunology
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / prevention & control*
  • Helminths / immunology*
  • Humans
  • Insulin-Secreting Cells / immunology*
  • Insulin-Secreting Cells / pathology*
  • Interleukin-10 / immunology
  • Interleukin-4 / immunology
  • Macrophages / immunology
  • Natural Killer T-Cells / immunology
  • T-Lymphocytes, Regulatory / immunology*
  • Th2 Cells / immunology
  • Transforming Growth Factor beta / immunology


  • IL10 protein, human
  • IL4 protein, human
  • Transforming Growth Factor beta
  • Interleukin-10
  • Interleukin-4