Parasitic infections as immunomodulatory modifiers of chronic obstructive pulmonary disease
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous inflammatory lung disorder in which bacterial and viral infections are established contributors to exacerbation, parasitic infection remains underexplored in COPD immunopathology. Objective To critically synthesize evidence that parasitic infections modify COPD immunopathology and to identify clinically relevant implications and research priorities. Methods PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched for publications from January 1985 to July 2026; Google Scholar and reference lists supplemented retrieval. Evidence was synthesized narratively and classified as direct COPD-specific clinical evidence, indirect human pulmonary evidence, animal-model evidence, or mechanistic evidence. Results Infections with helminths and protozoa may influence the pathophysiology of COPD by modulating the type 1 immune response through type 2 polarization, expansion of regulatory T cells, eosinophilia, systemic immune activation, and alterations to the microbiome. These mechanisms may influence inflammatory phenotypes and exacerbation susceptibility. Direct COPD-specific evidence is limited. Most support derives from pulmonary parasitic disease, observational studies, animal models, or mechanistic inference. Clinically, parasitic eosinophilia may confound COPD phenotyping, and occult Strongyloides stercoralis infection is particularly important when systemic corticosteroids are considered. Conclusion Current evidence supports a biologically possible role for parasitic infections as modifiers of COPD immunopathology, but does not establish causality or routine parasite-driven COPD. Prospective, phenotype-stratified studies integrating parasitological and immunological analyses are required, particularly in endemic populations.
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BibTeX
@article{grumelli2026parasitic,
title = {{Parasitic infections as immunomodulatory modifiers of chronic obstructive pulmonary disease}},
author = {Sandra Grumelli},
journal = {International Journal of Immunopathology and Pharmacology},
year = {2026},
month = oct,
doi = {10.1177/03946320261490459},
url = {https://doi.org/10.1177/03946320261490459},
note = {CC BY},
}
RIS
TY - JOUR
TI - Parasitic infections as immunomodulatory modifiers of chronic obstructive pulmonary disease
AU - Sandra Grumelli
PY - 2026
DA - 2026/10/23
JO - International Journal of Immunopathology and Pharmacology
DO - 10.1177/03946320261490459
UR - https://doi.org/10.1177/03946320261490459
AB - Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous inflammatory lung disorder in which bacterial and viral infections are established contributors to exacerbation, parasitic infection remains underexplored in COPD immunopathology. Objective To critically synthesize evidence that parasitic infections modify COPD immunopathology and to identify clinically relevant implications and research priorities. Methods PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched for publications from January 1985 to July 2026; Google Scholar and reference lists supplemented retrieval. Evidence was synthesized narratively and classified as direct COPD-specific clinical evidence, indirect human pulmonary evidence, animal-model evidence, or mechanistic evidence. Results Infections with helminths and protozoa may influence the pathophysiology of COPD by modulating the type 1 immune response through type 2 polarization, expansion of regulatory T cells, eosinophilia, systemic immune activation, and alterations to the microbiome. These mechanisms may influence inflammatory phenotypes and exacerbation susceptibility. Direct COPD-specific evidence is limited. Most support derives from pulmonary parasitic disease, observational studies, animal models, or mechanistic inference. Clinically, parasitic eosinophilia may confound COPD phenotyping, and occult Strongyloides stercoralis infection is particularly important when systemic corticosteroids are considered. Conclusion Current evidence supports a biologically possible role for parasitic infections as modifiers of COPD immunopathology, but does not establish causality or routine parasite-driven COPD. Prospective, phenotype-stratified studies integrating parasitological and immunological analyses are required, particularly in endemic populations.
SN - 2058-7384
SN - 0394-6320
ER -