 | THE LYMPHATIC CONTINUUM: Lymphatic Biology and Disease
Copyright © 2002 by the New York Academy of Sciences
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Annals of the New York Academy of Sciences 979:131-142 (2002)
© 2002 New York Academy of Sciences
The Pathogenesis of Filarial Lymphedema
Is it the Worm or Is It the Host?
PATRICK J. LAMMIEa,
KAREN T. CUENCOb AND
GEORGE A. PUNKOSDYa,c
aDivision of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA
bDepartment of Human Genetics, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
cDepartment of Cell Biology, University of Georgia, Athens, Georgia, USA
Address for correspondence: Patrick J. Lammie, Ph.D., Division of Parasitic Diseases/F13, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341. Voice: 770-488-4054; fax: 770-488-4108.
PJL1{at}cdc.gov
Ann. N.Y. Acad. Sci. 979: 131-142 (2002).
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.
Key Words: Lymphatic filariasis • Wuchereria bancrofti • lymphedema
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