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Short Communication | DOI: https://doi.org/10.31579/2640-1045/227
1Department of Public Health and Institute of Medical and Biotechnology Research, Faculty of Health Sciences, University of Carabobo, Venezuela.
2Department of Public Health, Faculty of Health Sciences, University of Carabobo, Venezuela.
3School of Medicine, Faculty of Health Sciences, University of Carabobo, Venezuela.
*Corresponding Author: Gilberto Bastidas, Department of Public Health and Institute of Medical and Biotechnology Research, Faculty of Health Sciences, University of Carabobo, Venezuela.
Citation: Gilberto Bastidas, Daniel Bastidas, Geraldine B. Delgado, (2025), Involvement of Parasites in Host Cardiometabolic Disorders, J. Endocrinology and Disorders, 9(5): DOI:10.31579/2640-1045/227
Copyright: © 2025, Gilberto Bastidas. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 20 October 2025 | Accepted: 28 October 2025 | Published: 10 November 2025
Keywords: parasites; cardiometabolic disorders; diabetes mellitus; obesity; cytokines
Background: Parasitic diseases are considered a serious public health problem for humans due to their widespread distribution and high frequency, especially in low- to middle-income countries. However, they appear to have a benign effect on cardiometabolic diseases. Therefore, the objective of this article is to present relevant information in this regard.
Materials and Methods: A documentary review of existing information related to parasitic diseases and their role in metabolic disorders was conducted. Based on the analysis of the main aspects found, the key elements of this interaction are presented.
Results: For example, by reducing circulating pro-inflammatory cytokines and increasing anti-inflammatory cytokines, which affect the pathogenetic mechanism, nutrient absorption, and the intestinal ecosystem, parasites and their antigens may contribute to improvements in the clinical presentation of chronic metabolic diseases.
Conclusion: It is evident that there is a complex and dynamic interaction between parasitosis and cardiometabolic disorders that is beneficial to the host, a result of coevolution and clearly generalizable to the human host population.
In rural and marginal urban areas of tropical and subtropical regions of low- and middle-income countries, parasitic infections represent a major public health problem (affecting approximately a quarter of the world's population) due to their endemicity in many of these countries, their widespread distribution, and their high morbidity and mortality rates. Parasitic diseases, specifically their pathogenesis, are determined by risk factors related to the environment and hygiene (access to drinking water and sanitation, humid environments, and barefoot walking habits), diet (contaminated food and untreated water), contact with animals and carriers, and individual factors (immunosuppression and malnutrition) [1-4].
Intestinal parasites have the highest prevalence, affecting 3.5 billion people worldwide, especially Ascaris lumbricoides, Schistosoma haematobium, Trichuris trichiura, Ancylostoma duodenale, Hymenolepis nana, Cryptosporidium spp., and Entamoeba histolytica, with 39 million disability-adjusted life years worldwide. In addition to the characteristic clinical presentations that define the disease, they are believed to participate in the genesis and/or progression of cardiometabolic disorders in the host, including obesity, metabolic syndrome, atherosclerosis, and type II diabetes mellitus (T2DM) (a chronic disorder with persistent hyperglycemia), which are associated with a lower quality of life and significant mortality [3, 5-8].
Since parasites can regulate the metabolism and immunity of the host in order to ensure its survival, whether or not it is a harmonious symbiotic relationship, it is necessary to show the possible association between metabolic disorders and parasitic infections, the main objective of this paper [3, 8, 9].
Discussion
There is a complex and dynamic relationship between parasitic infections and metabolic disorders, with mutual influence. For example, parasites and their antigens contribute to reducing blood glucose and improving insulin sensitivity by affecting metabolism, nutrient absorption, and the intestinal ecosystem as a pathogenetic mechanism, especially through a reduction in circulating pro-inflammatory cytokines and an increase in anti-inflammatory cytokines. On the other hand, a mechanism that allows for glycemic control is the depletion of the body's energy sources, which leads to weight loss, as well as the manipulation of the intestinal microbiome, both of which play a key role in blood glucose homeostasis [3, 10-13].
The regulatory role of parasites (e.g., eggs of the helminth Schitosoma spp.) in T2DM has been reported (with associated measures such as HbA1c, basal and postprandial glycemia and insulin, and pancreatic inflammation by histopathological analysis). However, age and other confounding factors should be considered in the interpretation of this and other findings from the metabolic perspective of the underlying mechanism of parasitic survival in patients with T2DM marked by humoral immunity disorders, innate immunity dysregulation, multiorgan impairment, and gut microbiota alterations (which can lead to mixed parasitic infections), as these patients may present generalized immune weakness and reduced T-cell responses [3, 14].
In this sense, the polarization of macrophages to M2 by helminths is involved in the alleviation of host metabolic diseases, with the aim of ensuring their survival. This strategy is effective against diseases related to metabolic disorders, since macrophage activation (M1) generates mild but persistent inflammation, which leads to obesity and related syndromes in the host. In this regard, studies with Echinococcus granulosus larvae in mice reveal increased lipolysis of adipose tissue in these animals, accompanied by increased arginine metabolism and activation of the PPAR-γ pathway, which plays a key role in M2 polarization. Furthermore, administration of antiparasitic treatment worsens glycemic control [15-21].
Obesity-induced cognitive decline can be limited by the effective inactivation of macrophages (M1) and their polarization to M2, as well as by the reduction of neuroinflammation induced by microglia and astrocytes in the brain by E. granulosus larvae (in the experimental mouse model). Furthermore, the immunoregulatory omega-1 glycoprotein from S. mansoni improves metabolic homeostasis in obese mice by inhibiting food intake. Succinate also regulates the immune response in macrophages by interacting with its receptor (G protein-coupled receptor 91 [GPR91] or succinate receptor 1 [SUCNR1]), which plays an important role in reducing overweight in the host [17, 19, 22-26].
Randomized trials report lower baseline levels of total and LDL cholesterol, and triglycerides, with increased HDL cholesterol (the risk of cardiovascular disease increases with HDL levels below 40 mg/dL) in subjects with infections with S. mansoni, Strongyloides stercoralis, and Fasciola hepatica (effects observed especially in parasites that affect the liver by altering intrahepatic fat processing). This is directly related to the intensity of the infection, but inversely related to the administration of anthelmintic treatment, since the average LDL cholesterol increases in those undergoing antiparasitic treatment [19, 27].
Regarding the measurement of parameters related to metabolic syndrome, studies in subjects infected with parasites reported lower body weight, blood glucose levels, insulin levels, and insulin resistance. The cardioprotection induced by parasitic infections appears to be greater in adult men than in the opposite sex, and the beneficial effects may derive from different mechanisms in young and older adults. However, the existing information in this regard is inconclusive, therefore, more rigorous studies are required to elucidate these arguments [19, 28].
Coronary artery disease and heart attack are decreased with parasitic infection, because findings show fewer atherosclerotic plaques in the aorta, carotid sinus, and other arteries, thereby improving blood flow to the heart. Likewise, parasitic infection decreases fat deposition in the kidneys and glomerular damage. However, an association between parasitic disease and blood pressure control is not possible [19, 26, 29].
Conclusion
Parasitic diseases affect a large portion of the world's population, with a sustained increase in morbidity and mortality, as well as serious complications, primarily in low- to middle-income countries. Human health, in relation to cardiometabolic disorders, may benefit from the coevolution between humans and parasites, as they have coexisted for millennia. Despite the variations between different studies in relation to sample size, population, area (urban, rural, endemic and non-endemic) and season of the study, the parasites detected, risk factors for metabolic diseases (alcoholism, smoking, among others), and the protocol for managing metabolic disorders, there is undoubtedly a beneficial effect of parasitic infections on these chronic diseases and their loss with antiparasitic treatment, through mechanisms such as the polarization of macrophages to the M2 type response, with an immediate reduction in the inflammatory response, which foresees a new perspective for the prevention of metabolic diseases that justify further research in this regard.
Conflict of interest: The author certifies that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Funding: The author certifies that there is no funding from any financial organization regarding the material discussed in the manuscript.
Author’s contributions: All authors read and approved the final version of the manuscript.
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Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
