Schistosoma haematobium, the infectious agent responsible for urogenital
schistosomiasis, infects over 112 million people annually in Sub-Saharan Africa alone.
Despite a complicated life-cycle within the human host, the vast majority of clinical
manifestations occur in response to eggs deposited into the bladder and ureter walls by
adult worms. Egg-associated inflammatory lesions feature markedly dysregulated
fibrosis responsible for obstructive disease, and urothelial alterations linked to human
bladder cancers. Epidemiologic evidence suggests that S. haematobium is responsible
for 32 million cases of dysuria, 10 million cases of hydronephrosis, and 150,000 deaths
from renal failure annually, making S. haematobium the world’s deadliest schistosome.
Despite the fundamental role of urogenital pathology in human disease, few animal
models have been able to recreate natural infection. This review gathers the existing
body of knowledge regarding the immunological events during S. haematobium
infection, and surveys novel S. haematobium infection models to reflect on how we can
move forward towards understanding both the pathologic and protective immune
responses to the world’s deadliest schistosome.
Keywords: Bladder, cancer, co-infection, eosinophils, fibrosis, granuloma,
haematobium, immunity, Immunoglobulin-E, Immunoglobulin-G4, immunemodulatory,
immunopathology, injection, innate, Interleukin-10, Interleukin-5,
Schistosoma, schistosomiasis, urogenital, urothelial.