Filariasis: Present Status and Future Challenges

  • Eric A. Ottesen


There are seven filarial parasites affecting over 100,000,000 individuals worldwide (Table 1) (1) . Despite these impressive statistics as recently as 15 years ago, filariasis was still considered to be a “primitive” discipline. The initiation of the UNDP/World Bank/WHO Special Programme in Tropical Disease Research (TDR) has highlighted the importance of filariases, and advances in immunology have led to an increased awareness of many issues of great practical significance. While the prospects for further advances are promising, there still remain a number of significant hindrances. From a positive perspective, these will become challenges for future work. The purposes of this review are to summarize our understanding of the filariases, to identify why we have not progressed further, and to suggest a direction for future research on filarial infections and disease.


Adult Worm Lymphatic Filariasis Future Challenge Past Infection Parasite Antigen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    WHO (1984) Filariasis-Report of the Fourth Expert Committee, Technical Report Series No. 702. Geneva, World Health OrganizationGoogle Scholar
  2. 2.
    Sasa M (1976) Human filariasis. Baltimore, University Park PressGoogle Scholar
  3. 3.
    WHO (1987) Expert Committee on Onchocerciasis — Third Report, Technical Report Series No. 752. Geneva: World Health OrganizationGoogle Scholar
  4. 4.
    Ottesen EA (1990) The filariases and tropical pulmonary eosinophilia. In: Warren KS, Mahmoud AAF (eds) Tropical and geographical medicine. New York, McGraw-Hill, pp 407–428Google Scholar
  5. 5.
    Dreyer G, Ottesen EA, Galdino E, Andrade L, Rocha A, Medeiros Z, Moura I, Casimiro I, Beliz F, Coutinho A (1992) Renal abnormalities in microfilaremic patients with bancroftian filariasis. Am J Trop Med Hyg (in press)Google Scholar
  6. 7.
    Nutman TB, Miller KD, Mulligan M, Ottesen EA (1986) Loa loa infection in temporary residents of endemic regions: recognition of a hyperresponsive syndrome with characteristic clinical manifestations. J Infect Dis 154: 10–18PubMedCrossRefGoogle Scholar
  7. 7.
    Ottesen EA (1989) Filariasis now. Am J Trop Med Hyg 41: 9–17PubMedGoogle Scholar
  8. 8.
    Ottesen EA (1980) Immunopathology of lymphatic filariasis in man. Springer Semin Immunopathol 2: 373–385CrossRefGoogle Scholar
  9. 9.
    Ottesen EA, Skvaril F, Tripathy SP, Poindexter RW, Hussain R (1985) Prominence of IgG4 in the IgG antibody response to human filariasis. J Immunol 134: 2707–2712PubMedGoogle Scholar
  10. 10.
    Suswillo RR, Doenhoff MJ, Denham DA (1981) Successful development of Brugia pahangi in T-cell deprived CBA mice. Acta Trop 1981 38: 305–308Google Scholar
  11. 11.
    Vincent AL, Vickery AC, Lotz MJ, Desai U (1984) The lymphatic pathology of Brugia paahangi in nude (athymic) and thymic mice C3H/HeN. J Parasitol 70: 48–56PubMedCrossRefGoogle Scholar
  12. 12.
    Vickery AC, Albertine KH, Nayar JK, Kwa BH (1991) Histopathology of Brugia malayi infected nude mice after immune-reconstitution. Acta Trop 49: 45–55PubMedCrossRefGoogle Scholar
  13. 13.
    Philipp M, Davis TB, Storey N, Carlow CKS (1988) Immunity in filariasis: perspectives for vaccine development. Ann Rev Microbiol 42: 685–716CrossRefGoogle Scholar
  14. 14.
    Ward DJ, Nutman TB, Zea-Flores G, Portocarrero C, Lujan A, Ottesen EA (1988) Onchocerciasis and immunity in humans: enhanced T cell responsiveness to parasite antigen in putatively immune individuals. J Infect Dis 157: 536–543PubMedCrossRefGoogle Scholar
  15. 15.
    Freediman DO, Nutman TB, Ottesen EA (1989) Protective immunity in bancroftian filariasis. Selective recognition of a 43-kD larval stage antigen by infection-free individuals in an endemic area. J Clin Invest 83: 14–22CrossRefGoogle Scholar
  16. 16.
    Weil GJ (1990) Parasite antigenemia in lymphatic filariasis. Exp Parasitol 71 : 353–356PubMedCrossRefGoogle Scholar
  17. 17.
    Forsyth KP, Spark R, Kazura J, Brown GV, Peters P, Heywood P, Dissanayake S, Mitchell GF (1985) A monoclonal antibody-based immunoradiometric assay for detection of circulating antigen in bancroftian filariasis. J Inmunol 5134: 1172–1177Google Scholar
  18. 18.
    More SJ, Copeman DB (1990) A highly specific and sensitive monoclonal antibody-based ELISA for the detection of circulating antigen in bancroftian filariasis. Trop Med Parasitol 41: 403–406PubMedGoogle Scholar
  19. 19.
    Chandrashekar R, Ogunrinade AF, Alvarez RM, Kale OO, Weil GJ (1990) Circulating immune complex-associated parasite antigens in human onchocerciasis. J Infect Dis 162: 1159–1164PubMedCrossRefGoogle Scholar
  20. 20.
    Lal RB, Ottesen EA (1988) Enhanced diagnostic specificity in human filariasis by IgG4 antibody assessment. J Infect Dis 158: 1034–1037PubMedCrossRefGoogle Scholar
  21. 21.
    Kwan-Lim G-E, Forsyth KP, Maizels RM (1990) Filarial-specific IgG4 response correlates with active Wuchereria bancrofti infection. J Immunol 145: 4298–4305PubMedGoogle Scholar
  22. 22.
    Ottesen EA (1987) Description, mechanisms and control of reactions to treatment in the human filariases. Ciba Fndn Symp 127: 265–283Google Scholar
  23. 23.
    Remme J, De Sole G, Dadzie KY, Alley ES, Baker RHA, Habbema DJF, Plaisier AP, van Oort-Marssen GJ, Samba EM (1990) Large scale ivermectin distribution and its epidemiological consequences. Acta Leidensia 59: 177–192PubMedGoogle Scholar
  24. 24.
    Ottesen EA (1985) Efficacy of diethylcarbamazine in eradicating infection with lymphatic-dwelling filariae in humans. Rev Infect Dis 7: 341–356PubMedCrossRefGoogle Scholar
  25. 25.
    Chakravertty RK, Srivastav VK, Srivastava SP, Chand P, Rao CK (1987) Prophylactic effect of diethylcarbamazine on Wuchereria bancrofti filariasis. J Commun Dis 19: 128–135PubMedGoogle Scholar
  26. 26.
    Nutman TB, Miller KD, Mulligan M, Reinhardt GN, Currie BJ, Steel C, Ottesen EA (1988) Diethylcarbamazine prophylaxis for human loiasis. Results of a double-blind study. N Engl J Med 319: 752–756PubMedCrossRefGoogle Scholar
  27. 27.
    Dull HB (1990) Mectizan donation and the Mectizan expert committee. Acta Leidensia, 1990 59: 399–404Google Scholar

Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Eric A. Ottesen
    • 1
  1. 1.Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaUSA

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