Lymphatic filariasis

Two forms of lymphatic filariasis are found in India. The Bancroftian form is the most common and accounts for more than 90% of the disease whereas Bmgian filariasis accounts for the rest. In a study carried out in India (6) in 40 patients with Wuchereria Bancwfti filariasis treated with single oral doses, all of the dose levels chosen (25, 50, 100, and 200 mg/kg) were efficacious in clearing microfilariae from the blood of all patients treated. However, after three months some microfilaria recurred in the blood of most patients (Table 5). Further studies are planned and some are underway using different doses and regimens. Ivermectin still appears to hold promise as a new treatment for lymphatic filariasis. 

Freedman, D.O. (1998) Immune dynamics in the pathogenesis of human lymphatic filariasis. Parasitology Today 14, 229-234. 

Turner, P.F., Rockett, K.A., Ottesen, E.A., Francis, H., Awadzi, K. and Clark, I.A. (1994) Interleukin-6 and tumor necrosis factor in the pathogenesis of adverse reactions after treatment of lymphatic filariasis and onchocerciasis. Journal of Infectious Diseases 169, 1071-1075. 

Maizels, R.M., Sartono, E., Kurniawan, A, Partono, F., Selkirk, M.E. and Yazdanbash, M. (1995) T-cell activation and the balance of antibody isotypes in human lymphatic filariasis. Parasitology Today 11, 50-56. 

Fuhrman, J.A., Lane, W.S., Smith, R.F., Piessens, W.F. and Perler, F.B. (1992) Transmission-blocking antibodies recognize microfilarial chitinase in Brugian lymphatic filariasis. Proceedings of the National Academy of Sciences USA 89, 1548-1552. 

King, C.L. and Nutman, T.B. (1991) Regulation of the immune response in lymphatic filariasis and onchocerciasis. Immunology Today 12, A54-58. 

One likely reason for the prevalence of helminths is their undoubted ability to down-regulate the host immune system at both the antigen-specific and polyclonal levels [3], In many chronic diseases, such as schistosomiasis and lymphatic filariasis, peripheral blood T cells show dramatically impaired parasite antigen-specific responsiveness [4], as discussed in more detail below. Moreover, from early reports of immunosuppression in animal models of infection, to studies in Africa linking vaccine failure to heavy helminth infection, there is clear evidence that infections can diminish reactivity to bystander antigens, particularly with increasing intensity of... 

Our perspective is thus one of general significance to chronic infection, as well as one that will provide specific pathways to novel treatments of human schistosomiasis, and lymphatic filariasis. These two diseases represent a massive public health problem with 300 million people infected in the world today. Intervention by ablating parasite-specific Tregs in these patients will solve the specific problems of schistosomiasis and filarial diseases, while at the same time proving a principle which will be applicable to chronic infections in general. 

Babu S, Blauvelt CP, Kumaraswami V, Nutman TB Regulatory networks induced by hve parasites impair both Thl and Th2 pathways in patent lymphatic filariasis imphcations for parasite persistence. J Immunol 2006 176 3248-3256. 

Tisch DJ, Michael E, Kazura JW Mass chemotherapy options to control lymphatic filariasis A systematic review. Lancet Infect Dis 2005 5 514. [PMID 16048720]... 

Chagas, leishmaniasis, trypanosomiasis, lymphatic filariasis - individually or in... 

The UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) was established in 1975 in response to appeals from countries where neglected diseases are endemic. TDR addresses ten tropical diseases African trypanosomiasis, dengue, leishmaniasis, schistosomiasis, tuberculosis, Chagas disease, leprosy, lymphatic filariasis, and onchocerciasis. Its mission is ... 

Ottesen EA. 1980. The clinical spectrum of lymphatic filariasis and its immunological determinants. WIIO/FIIJHO 160-168. 

During the last four decades, microfilaricidal diethylcarbamazine [46] and macrofilaricidal suramin [47,48] have been used for the treatment of filariasis however, iboth of these drugs possess unwanted side-effects such as mazzotti reaction, toxicity, etc. Suramin is highly active against the adult worm of 0. volvulus [47] in humans, but it is very toxic to the kidney, liver and bone marrow and has other side-effects similar to DEC. DEC in the treatment of onchocerciasis produces severe mazzotti reaction (an allergic response due to rapid death of microfilariae) along with other side-effects such as pruritus and anaphylactic shock. However, the mass treatment of lymphatic filariasis with DEC was successful due to a lower and milder incidence of these adverse... 

The Ar-(5-nitro-2-furfurylidene)aminotetrahydro-2-( 17/)-pyrimidone developed in China has exhibited both macro- and microfilaricidal activity in humans against lymphatic filariasis [56, 57]. Besides these compounds, various other drugs such as amodiaquine, primaquine, furazolidone and metrifonate, also have been tested as filaricidal in humans and were found to be ineffective [58] however, levamisole [38, 59] has demonstrated some micro- and macrofilaricidal effects in humans at 100 mg/kg, but it is less effective than DEC and produces more severe side-effects. The mode of action of several antifilarial drugs has also been investigated and reviewed by Rew and Fetterer [60] and Subrahmanyam [38]. 

World Health Organization, Technical Report Series 702, Lymphatic Filariasis (1984). 

Krishnamoorthy K, Ramu K, Srividya A, Appavoo NC, Saxena NB, Lai S, Das PK. Cost of mass annual single dose diethylcarbamazine distribution for the large scale control of lymphatic filariasis. Indian J Med Res 2000 lll 81-9. 

Yazdanbakhsh M, Duym L, Aarden L, Partono F. Serum interleukin-6 levels and adverse reactions to diethylcarbama-zine in lymphatic filariasis. J Infect Dis 1992 166(2) 453-4. 

Dunyo SK, Nkrumah FK, Simonsen PE. A randomized double-blind placebo-controlled field trial of ivermectin and albendazole alone and in combination for the treatment of lymphatic filariasis in Ghana. Trans R Soc Trop Med Hyg 2000 94(2) 205-ll. 

The risk of severe adverse reactions is greater in lymphatic filariasis (55). 

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