Infection-stimulated or perinatally initiated idiotypic interactions can direct differential morbidity and mortality in schistosomiasis

In this and previous publications, we have described two areas of study tha t now converge, and that we propose provide insights into immunoregulatory processes that may develop during chronic endemic diseases and contribute t o the balance and chronicity of the essential host/parasite relationship. T he first area of study is that of idiotypic/antiidiotypic interactions with in human and experimental immune systems during Schistosoma mansoni infecti ons. The companion study concerns a naturally developing differential devel opment of morbidity and mortality during chronic experimental schistosomias is mansoni. Based on the data presented and reviewed, we propose that eithe r by six weeks of infection, or through perinatal idiotypic manipulation, t he immune system of the infected host is 'programmed' into responding eithe r with regulatory cross-reactive idiotypes or not, and that this commitment differentially controls multiple subsequent immune responses and can deter mine the degree of consequent morbidity and mortality due to schistosomiasi s.