Pampiglione Silvio, Rivasi Francesco, Gustinelli Andrea
Department of Veterinary Public Health and Animal Pathology, University of Bologna, Ozzano Emilia, Bologna, Italy.
Histopathology. 2009 Jan;54(2):192-204. doi: 10.1111/j.1365-2559.2008.03197.x.
To review 28 cases of human dirofilariasis reported in the last 30 years in the Old World and attributed, by their respective authors, to Dirofilaria immitis or a species of Dirofilaria other than D. repens.
Each case was analysed by examining the published accounts or by discussions with the authors, who were interviewed whenever possible.
On the basis of these analyses we conclude that there is as yet no proof demonstrating with certainty that Old World D. immitis plays a pathogenic role in humans. It remains to be explained why D. immitis causes pulmonary infections in humans in the Americas while, in the Old World, this location appears, instead, to be always associated with D.repens, even though the former species is at times more frequent than the latter both in dogs and in the vectors. To explain this apparently different pathogenic power, two hypotheses are proposed: (i) there are perhaps twin populations with different genotypes on the two sides of the Atlantic, with different infective capacity for man and dog; (ii) the infective capacity to humans of the parasite could be modified, only in the Old World, by some unidentified factor, possibly inherent to the vector, that affects the complex mechanism of the vector-parasite relationship, affecting the survival of the larvae.
回顾过去30年在旧大陆报道的28例人体恶丝虫病病例，这些病例由各自的作者归因于犬恶丝虫或除匐行恶丝虫之外的其他恶丝虫属物种。
通过查阅已发表的报告或与作者讨论对每个病例进行分析，尽可能对作者进行访谈。
基于这些分析，我们得出结论，目前尚无确凿证据表明旧大陆的犬恶丝虫在人类中起致病作用。美洲的犬恶丝虫会导致人类肺部感染，而在旧大陆，这种情况似乎总是与匐行恶丝虫有关，这一点仍有待解释，尽管在犬类和传播媒介中，前一物种有时比后一物种更为常见。为了解释这种明显不同的致病力，提出了两种假说：（i）大西洋两岸可能存在具有不同基因型的孪生种群，对人和犬具有不同的感染能力；（ii）在旧大陆，寄生虫对人类的感染能力可能仅因某些未明因素而改变，这些因素可能是传播媒介所固有的，影响传播媒介与寄生虫关系的复杂机制，进而影响幼虫的存活。
