HELMINTH INFECTIONS: IMMUNOLOGICAL EVASION AND METABOLIC EXPLOITATION — PATHOGENESIS AND NOVEL THERAPEUTIC TARGETS

This systematic review aims to decode the mechanisms of metabolic exploitation and immune evasion employed by helminths that disrupt host homeostasis, as well as their objective clinical consequences. The study was conducted based on sources selected from international databases such as Scopus, Web of Science, and PubMed, covering the last decade (2016–2026) and complying with PRISMA standards. The analysis demonstrates that helminths activate anaerobic cascades (notably phosphoenolpyruvate carboxykinase, PEPCK) to utilize host energy substrates and release cytotoxic metabolites into the tissue microenvironment. In parallel, parasite-derived excretory-secretory (ES) mediators polarize macrophages toward a pathological M2 phenotype and artificially shift the Th2/Treg tolerance axis into a dominant state. Such biochemical interference results in pronounced oxidative stress, granulomatous fibrosis of tissues, and functional decompensation of organs.