CLINICAL AND THERAPEUTIC STUDIES IN HUMAN FILARIASIS

最近的临床研究已经定义了患有 对感染丝虫的自然免疫力。一些人感染了 个人可能会在很长一段时间内保持微丝状体畸形，而不是 发展为显性淋巴病理，但其他人发展为此类病理 可在持续性微丝粒细胞性贫血或 在微丝核血症症清除后。 应用聚合酶链式反应扩增非霍奇金淋巴瘤患者皮肤标本中寄生虫DNA 盘尾丝虫病提高了诊断的敏感性和特异性， 检测已配置为现场的酶联免疫吸附试验格式 适用。类似的努力也在进行中，以检测寄生虫DNA 淋巴丝虫病，但敏感性尚未优于诊断 通过寄生虫学或抗原检测手段。 比较两个或七个1周疗程的DEC的治疗试验 超过15个月的淋巴丝虫病显示出相同的治疗效果 影响，但最重要的是，第一次显示循环 丝虫抗原是一种很好的、可读的活动性标志物。 班氏丝虫病。其他研究表明，每年一次 剂量的伊维菌素或DEC在减少 班氏丝虫病中的微丝虫病，或者单独用药(或 合在一起)将适合于控制程序。相比之下，即使是 三个为期三周的DEC疗程只能治愈大约三分之二的 患有血吸虫病的外籍人士；需要更有效的化疗。

Recent clinical studies have defined the presence of individuals with natural immunity to infection with filarial parasites. Some infected individuals may remain microfilaremic over long periods of time, without developing overt lymphatic pathology, but others develop such pathology that can develop either in the setting of persistent microfilaremia or after microfilaremia has cleared. PCR-based amplifications of parasite DNA in skin snips from patients with onchocerciasis has increased diagnostic sensitivity and specificity, and the assays have been configured into an ELISA format that is field applicable. Similar efforts are underway to detect parasite DNA in lymphatic filariasis, but sensitivity is not yet superior to diagnosis by parasitologic or antigen-detection means. A treatment trial comparing two or seven 1-week courses of DEC for lymphatic filariasis given over 15 months showed equivalent therapeutic effects but, most importantly, showed for the first time that circulating filarial antigen is an excellent and readable marker of active bancroftian filarial infection. Other studies showed that single yearly doses of ivermectin or DEC are extremely effective in reducing microfilaremia in bancroftian filariasis, and either drug alone (or together) would be appropriate for control programs. In contrast, even three 3-week courses of DEC could cure only about two thirds of expatriates with loiasis; more effective chemotherapy is needed.