The Human Filaria Loa loa: Update on Diagnostics and Immune Response

Loa loa loiasis was considered an anecdotal disease 30 years ago. Its spread in Equatorial Africa and the side effects associated with mass drug administration programs against filariasis in co-endemic areas have drawn the attention of the international research community. Progress in research condu...

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Bibliographic Details
Published in:Research and reports in tropical medicine 2022-08, Vol.13, p.41-54
Main Authors: Dieki, Roland, Nsi-Emvo, Edouard, Akue, Jean Paul
Format: Article
Language:English
Subjects:
Allergic reaction
Allergy
Anergy
Antigen-antibody reactions
Antigens
Biomarkers
Blood
Cross-reactivity
diagnostics
Edema
Epidemiology
Expatriates
Filariasis
Global health
immune anergy
immune evasion
Immune response
Immunoassay
Immunoglobulin E
Immunoglobulin G
Immunological unresponsiveness
Infections
Infectious diseases
Isotypes
Loa loa
Medical diagnosis
Medical examination
Mortality
Nematoda
Parasites
Parasitic diseases
Peripheral blood
Polymerase chain reaction
Public health
Review
Tropical diseases
Urban areas
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Summary:Loa loa loiasis was considered an anecdotal disease 30 years ago. Its spread in Equatorial Africa and the side effects associated with mass drug administration programs against filariasis in co-endemic areas have drawn the attention of the international research community. Progress in research conducted to date has provided insight into the immunobiology of this parasite. An interesting finding reported in several studies is that 70% of individuals with loiasis do not carry microfilariae in their blood, and 30% are microfilaremic, suggesting the involvement of several immunological mechanisms, as shown by elevated specific IgG4 and IgE levels signifying a potential cross-linking mechanism between the two isotypes via L. loa antigen to prevent allergy. A mechanism of anergy in the appearance of microfilariae in the peripheral blood results in immunological unresponsiveness in individuals with microfilariae. There is an interaction between other pathogens (parasites, bacteria, viruses) in individuals co-infected with L. loa. The strong antigen cross-reactivity between L. loa and lymphatic filarial worms warrants a re-evaluation of the distribution of the latter in co-endemic regions. The mechanism of concomitant immunity observed in the elimination of microfilariae or infective larvae (third- stage larvae, L3) may be used for the conception of an immunoprophylactic strategy. Keywords: Loa loa, diagnostics, immune anergy, immune evasion, cross-reactivity
ISSN:1179-7282
1179-7282
DOI:10.2147/RRTM.S355104