CLINICAL AND THERAPEUTIC STUDIES IN HUMAN FILARIASIS

最近的临床研究已经定义了患有 对感染的天然免疫力持续至少17年。一些人 在同一时期内，感染者可能仍有微丝分裂。 没有发展出明显的淋巴病变，但其他 发展这样的病理，可以在以下两种情况下发展 持续性微丝虫病或在微丝虫病清除后。 遗传因素似乎易患热带肺病 嗜酸性粒细胞增多综合征；家族性研究正在进行中，以确定 机械装置。 用聚合酶链式反应扩增病人皮肤组织中的寄生虫DNA 患有盘尾丝虫病提高了诊断的敏感性 特异性，检测结果已配置为一种酶联免疫吸附试验 这是适用于现场的。类似的努力也在进行中，以检测 淋巴丝虫病中的寄生虫DNA，但敏感性尚未确定 优于通过寄生虫学或抗原检测手段进行诊断。 因为库克群岛的人口研究相对较少 感染，比较2或7个一周疗程的DEC的治疗试验 超过15个月的药物显示出相同的治疗效果，但大多数 重要的是，第一次表明循环中的丝虫病 抗原是活动性班氏杆菌极好的可读性标记物。 丝虫感染。其他研究表明，每年单一剂量的 伊维菌素或DEC在减少微丝虫病方面非常有效 在班克罗夫斯坦丝虫病中，无论是单独用药(或联合用药)都能 适用于控制程序。相比之下，即使是3个三周的 DEC疗程只能治愈约2/3的外籍人士的血吸虫病； 需要更有效的化疗。

Recent clinical studies have defined the presence of individuals with natural immunity to infection lasting at least 17 years. Some infected individuals may remain microfilaremic over this same period 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. Genetic factors appear to predispose one to develop tropical pulmonary eosinophilia syndrome; familial studies are underway to define the mechanisms. 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. Because the Cook Islands population studied was relatively lightly infected, the treatment trial comparing 2 or 7 one-week courses of DEC 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 3 three-week courses of DEC could cure only about 2/3 of expatriates with loiasis; more effective chemotherapy is needed.