Lammie Patrick J, Cuenco Karen T, Punkosdy George A
Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Ann N Y Acad Sci. 2002 Dec;979:131-42; discussion 188-96. doi: 10.1111/j.1749-6632.2002.tb04874.x.
Our understanding of the pathogenesis of filarial lymphedema, although evolving, is still limited. Recurrent bacterial infections play a major role in the progression of lymphedema to elephantiasis, but the host and parasite factors that trigger disease development are not known. Field studies in Haiti show that lymphedema and host responses to parasite antigens cluster in families, consistent with the hypothesis that host genes influence lymphedema susceptibility. The recent recognition that filarial parasites harbor the endosymbiotic bacteria, Wolbachia, also raises questions about the potential contribution of the inflammatory response to Wolbachia antigens to lymphedema development. In this review, we discuss potential risk factors for lymphedema and try to integrate these in a model of pathogenesis.
我们对丝虫性淋巴水肿发病机制的理解，尽管在不断发展，但仍然有限。反复的细菌感染在淋巴水肿发展为象皮肿的过程中起主要作用，但引发疾病发展的宿主和寄生虫因素尚不清楚。海地的实地研究表明，淋巴水肿和宿主对寄生虫抗原的反应在家族中聚集，这与宿主基因影响淋巴水肿易感性的假设一致。最近认识到丝虫寄生虫携带内共生细菌沃尔巴克氏体，这也引发了关于炎症反应对沃尔巴克氏体抗原在淋巴水肿发展中的潜在作用的问题。在这篇综述中，我们讨论了淋巴水肿的潜在危险因素，并试图将这些因素整合到一个发病机制模型中。
