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However, the pathogenesis of spirochetes remains unclear, as different types of spirochetes play pathogenic roles through different pathogenic substances and mechanisms. To survive and spread in the host, spirochetes have evolved complicated strategies to evade host immune responses. In this review, we aimed to provide a comprehensive overview of immune evasion strategies in spirochetes infection. These strategies can be explained from the following points: (i) Antigenic variation: random, unidirectional, and segmental conversion of the gene to evade immune surveillance; (ii) Overcoming the attack of the complement system: recruitment of host complement regulators, cleavage of complement components and inhibition of complement activation to evade immune defenses; (iii) Interfering with immune cells to regulating the immune system; (iv) Persistent infection: invading and colonizing the host cell to escape immune damage.<\/jats:p>","DOI":"10.1002\/jcla.24414","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T08:04:12Z","timestamp":1649664252000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Subversion of the immune response of human pathogenic spirochetes"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3355-6190","authenticated-orcid":false,"given":"Jielite","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory The Second Affiliated Hospital, Hengyang Medical School, University of South China  Hengyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7402-6084","authenticated-orcid":false,"given":"Jinlin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory The Second Affiliated Hospital, Hengyang Medical School, University of South China  Hengyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafeng","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory The Second Affiliated Hospital, Hengyang Medical School, University of South China  Hengyang China"},{"name":"Institution of Pathogenic Biology Medical College Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study University of South China  Hengyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoran","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory The Second Affiliated Hospital, Hengyang Medical School, University of South China  Hengyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"PasterBJ BreznakJA.Cristispira. 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