The Road to Eliminating Filarial Diseases—Treatment, Diagnostic and Surveillance Strategies

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Parasitic Pathogens".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 8158

Special Issue Editors


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Guest Editor
Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
Interests: filariae; drug development; Wolbachia; new antibiotics against filariae; anthelmintics

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Co-Guest Editor
Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn Venusberg-Campus 1, Building 63, Room 1G 003, D-53127 Bonn, Germany
Interests: NTDs; filarial infections (mouse and human); podoconiosis; immunomodulation by helminths and effects on concomitant infections and diseases

Special Issue Information

Dear Colleagues,

Human filariae such as Onchocerca volvulus, Wuchereria bancrofti and Brugia spp. are vector-borne parasitic nematodes that are endemic in tropical and subtropical regions. Approximately 1 billion individuals live in endemic regions where filarial diseases are a public health concern contributing to significant disability adjusted life years. Thus, efforts to control and eliminate filarial diseases were launched by the WHO in the 1970s. These strategies are mainly based on mass drug administration targeting the worm’s offspring (microfilariae), and are accompanied in part by vector control strategies. The World Health Assembly approved development and implementation of the WHO’s roadmap to attain the Sustainable Development Goals, which includes the halt of onchocerciasis transmission and elimination of lymphatic filariasis as a public health problem by 2030. Considerable progress has been made towards the elimination of these two diseases in some countries, but challenges like the risk of resurgence after stopping interventions remain, demanding intensive surveillance approaches and additional interventions. To tackle these challenges and fulfil the ambitious goal of filariasis elimination, additional and novel treatment, diagnostic, and surveillance strategies need to be implemented. Thus, for this Special Issue in Pathogens, we invite you to submit research articles, reviews, and short reports on aspects of anti-filarial drug development and treatment strategies, as well as surveillance and diagnostic approaches that will support the goal of eliminating filarial diseases.

Prof. Dr. Achim Hoerauf
Dr. Manuel Ritter
Guest Editors

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Keywords

  • filariae
  • anti-filarial treatment
  • diagnostic and surveillance approaches
  • anti-filarial drug development
  • elimination of filarial diseases
  • clinical trials

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Published Papers (4 papers)

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Research

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17 pages, 1750 KiB  
Article
Stage-Dependent Increase of Systemic Immune Activation and CCR5+CD4+ T Cells in Filarial Driven Lymphedema in Ghana and Tanzania
by Abu Abudu Rahamani, Sacha Horn, Manuel Ritter, Anja Feichtner, Jubin Osei-Mensah, Vera Serwaa Opoku, Linda Batsa Debrah, Thomas F. Marandu, Antelmo Haule, Jacklina Mhidze, Abdallah Ngenya, Max Demetrius, Ute Klarmann-Schulz, Michael Hoelscher, Christof Geldmacher, Achim Hoerauf, Akili Kalinga, Alexander Y. Debrah and Inge Kroidl
Pathogens 2023, 12(6), 809; https://doi.org/10.3390/pathogens12060809 - 7 Jun 2023
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Abstract
Chronic lymphedema caused by infection of Wuchereria bancrofti is a disfiguring disease that leads to physical disability, stigmatization, and reduced quality of life. The edematous changes occur mainly on the lower extremities and can progress over time due to secondary bacterial infections. In [...] Read more.
Chronic lymphedema caused by infection of Wuchereria bancrofti is a disfiguring disease that leads to physical disability, stigmatization, and reduced quality of life. The edematous changes occur mainly on the lower extremities and can progress over time due to secondary bacterial infections. In this study, we characterized participants with filarial lymphedema from Ghana and Tanzania as having low (stage 1–2), intermediate (stage 3–4), or advanced (stage 5–7) lymphedema to determine CD4+ T cell activation patterns and markers associated with immune cell exhaustion. A flow cytometry-based analysis of peripheral whole blood revealed different T cell phenotypes within participants with different stages of filarial lymphedema. In detail, increased frequencies of CD4+HLA-DR+CD38+ T cells were associated with higher stages of filarial lymphedema in patients from Ghana and Tanzania. In addition, significantly increased frequencies of CCR5+CD4+ T cells were seen in Ghanaian participants with advanced LE stages, which was not observed in the Tanzanian cohort. The frequencies of CD8+PD-1+ T cells were augmented in individuals with higher stage lymphedema in both countries. These findings show distinct activation and exhaustion patterns in lymphedema patients but reveal that immunological findings differ between West and East African countries. Full article
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12 pages, 1391 KiB  
Article
Reduced Type 2 Innate Lymphocyte Cell Frequencies in Patent Wuchereria bancrofti-Infected Individuals
by Ruth S. E. Tamadaho, Jubin Osei-Mensah, Kathrin Arndts, Linda Batsa Debrah, Alexander Y. Debrah, Laura E. Layland, Achim Hoerauf, Kenneth Pfarr and Manuel Ritter
Pathogens 2023, 12(5), 665; https://doi.org/10.3390/pathogens12050665 - 30 Apr 2023
Cited by 4 | Viewed by 1605
Abstract
Approximately 51 million individuals suffer from lymphatic filariasis (LF) caused mainly by the filarial worm Wuchereria bancrofti. Mass drug administration (MDA) programs led to a significant reduction in the number of infected individuals, but the consequences of the treatment and clearance of [...] Read more.
Approximately 51 million individuals suffer from lymphatic filariasis (LF) caused mainly by the filarial worm Wuchereria bancrofti. Mass drug administration (MDA) programs led to a significant reduction in the number of infected individuals, but the consequences of the treatment and clearance of infection in regard to host immunity remain uncertain. Thus, this study investigates the composition of myeloid-derived suppressor cells (MDSCs), macrophage subsets and innate lymphoid cells (ILCs), in patent (circulating filarial antigen (CFA)+ microfilariae (MF)+) and latent (CFA+MF−) W. bancrofti-infected individuals, previously W. bancrofti-infected (PI) individuals cured of the infection due to MDA, uninfected controls (endemic normal (EN)) and individuals who suffer from lymphoedema (LE) from the Western Region of Ghana. Frequencies of ILC2 were significantly reduced in W. bancrofti-infected individuals, while the frequencies of MDSCs, M2 macrophages, ILC1 and ILC3 were comparable between the cohorts. Importantly, clearance of infection due to MDA restored the ILC2 frequencies, suggesting that ILC2 subsets might migrate to the site of infection within the lymphatic tissue. In general, the immune cell composition in individuals who cured the infection were comparable to the uninfected individuals, showing that filarial-driven changes of the immune responses require an active infection and are not maintained upon the clearance of the infection. Full article
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12 pages, 455 KiB  
Article
Increased HIV Incidence in Wuchereria bancrofti Microfilaria Positive Individuals in Tanzania
by Jonathan Mnkai, Manuel Ritter, Lucas Maganga, Leonard Maboko, Willyhelmina Olomi, Petra Clowes, Jessica Minich, Agola Eric Lelo, Daniel Kariuki, Alexander Yaw Debrah, Christof Geldmacher, Michael Hoelscher, Elmar Saathoff, Mkunde Chachage, Kenneth Pfarr, Achim Hoerauf and Inge Kroidl
Pathogens 2023, 12(3), 387; https://doi.org/10.3390/pathogens12030387 - 28 Feb 2023
Cited by 2 | Viewed by 2143
Abstract
Background: Infections with Wuchereria bancrofti are associated with reduced immunity against concomitant infections. Indeed, our previous study described a 2.3-fold increased HIV incidence among individuals with W. bancrofti infection, as measured by the circulating filarial antigen of the adult worm. This new study [...] Read more.
Background: Infections with Wuchereria bancrofti are associated with reduced immunity against concomitant infections. Indeed, our previous study described a 2.3-fold increased HIV incidence among individuals with W. bancrofti infection, as measured by the circulating filarial antigen of the adult worm. This new study aimed to retrospectively determine microfilariae status of the participants to assess if the previously described increased HIV susceptibility was associated with the presence of MF in the same cohort. Methods: CFA positive but HIV negative biobanked human blood samples (n = 350) were analyzed for W. bancrofti MF chitinase using real time PCR. Results: The PCR provided a positive signal in 12/350 (3.4%) samples. During four years of follow-up (1109 person years (PY)), 22 study participants acquired an HIV infection. In 39 PY of W. bancrofti MF chitinase positive individuals, three new HIV infections occurred (7.8 cases per 100 PY), in contrast to 19 seroconversions in 1070 PY of W. bancrofti MF chitinase negative individuals (1.8 cases per 100 PY, p = 0.014). Conclusions: In the subgroup of MF-producing Wb-infected individuals, the HIV incidence exceeded the previously described moderate increased risk for HIV seen in all Wb-infected individuals (regardless of MF status) compared with uninfected persons from the same area. Full article
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7 pages, 1686 KiB  
Case Report
Subcutaneous Dirofilariosis of the Eyelid Brought to Poland from the Endemic Territory of Ukraine
by Beata Rymgayłło-Jankowska, Marta Ziaja-Sołtys, Beata Flis, Anna Bogucka-Kocka and Tomasz Żarnowski
Pathogens 2023, 12(2), 196; https://doi.org/10.3390/pathogens12020196 - 28 Jan 2023
Cited by 3 | Viewed by 1993
Abstract
We present the case of a 60-year-old man who was diagnosed with a subcutaneous nodule on the upper eyelid of his left eye. The patient reported multiple mosquito bites during numerous work trips to Ukraine. Histopathological examination of the nodule isolated during surgery [...] Read more.
We present the case of a 60-year-old man who was diagnosed with a subcutaneous nodule on the upper eyelid of his left eye. The patient reported multiple mosquito bites during numerous work trips to Ukraine. Histopathological examination of the nodule isolated during surgery suggested Dirofilaria repens infestation. The infection was brought to Poland from the territory of Ukraine. Ophthalmologists must be aware of uncommon presentations of parasitic infestations when they consider infections of the ocular adnexa. Full article
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