Filaria: Why Lymphoedema Develops After Adult Worms Die

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Discussion Overview

The discussion revolves around the phenomenon of lymphoedema developing after the death of adult filarial worms. Participants explore the relationship between the presence of adult worms, their death, and the subsequent immune response that may lead to lymphoedema. The scope includes theoretical and conceptual aspects of parasitology and immunology.

Discussion Character

  • Exploratory
  • Conceptual clarification
  • Debate/contested

Main Points Raised

  • One participant questions why lymphoedema develops after the death of adult filarial worms, suggesting that the removal of the worms should eliminate the disease.
  • Another participant asserts that the bodies of dead worms remain in the lymph nodes and decompose, potentially contributing to lymphoedema.
  • A follow-up inquiry raises whether a patient with only microfilaria in the blood, while adult worms remain alive, can still transmit the infection through mosquito bites.
  • One participant proposes that lymphoedema is not directly caused by living worms but rather by a T cell mediated immune response to antigens released upon the worms' death, along with potential secondary bacterial infections that may affect lymph vessel formation.
  • The extreme manifestation of lymphoedema, such as elephantiasis, is mentioned as a severe outcome of the condition.

Areas of Agreement / Disagreement

Participants express differing views on the mechanisms leading to lymphoedema after the death of adult filarial worms. There is no consensus on the exact causes or implications of these mechanisms.

Contextual Notes

Some assumptions about immune responses and the role of secondary infections remain unresolved. The discussion does not clarify the specific conditions under which lymphoedema develops or the full implications of the immune response to filarial antigens.

rajeshmarndi
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why after the filaria adult worms die you are prone to develop lymphoedema, instead one should get rid of the worm and the disease.

when one take medicine for filaria, it only kill the micro filaria in the blood and seems there is no lymphoedema as long the adult worm live in the lymphatic system. But lymphodema start once the adult worm live its lifespan and dies. Why?

Thanks.
 
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When the worms die, their bodies don't just disappear! They stay in the lymph nodes and rot.
 

Thanks for the reply.

Is a filaria patient who is under medication i.e microfilaria only in the blood get killed, but the adult worms are unaffected and remain in his lymphatic system. Is he also capable to spread the worm through mosquito bite?
When the worms die, their bodies don't just disappear! They stay in the lymph nodes and rot.

But other parasite/bacteria e.g malaria parasite are killed and removed from the body.
 
rajeshmarndi said:
why after the filaria adult worms die you are prone to develop lymphoedema, instead one should get rid of the worm and the disease.

when one take medicine for filaria, it only kill the micro filaria in the blood and seems there is no lymphoedema as long the adult worm live in the lymphatic system. But lymphodema start once the adult worm live its lifespan and dies. Why?

Thanks.

The reason is that lymphedema (LE) is not caused directly by the living worm, but by a T cell mediated immune response to filarial antigen mostly released when the worms die. There are also secondary bacterial infections which either alone or together with the primary infection, stimulate the release of growth factors which can interfere with the normal generation of lymph vessels. Neonates born in endemic areas will have heavy pathogen loads, but few symptoms because of acquired factors which down-regulate the immune response. LE, in the extreme case, can cause grotesque deformities in the lower extremities (elephantiasis). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784903/
 
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