2013, Number 4
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Dermatología Cosmética, Médica y Quirúrgica 2013; 11 (4)
Onchocerciasis: the delicate dance between a parasite, an endosymbiont and the host immune response
Ríos YJM, Ríos CM, Yuil RE, Mercadillo PP
Language: Spanish
References: 23
Page: 277-287
PDF size: 203.74 Kb.
ABSTRACT
Caused by the filarial nematode
Onchocerca volvulus, onchocerciasis
is a parasitic disease affecting some 37 million people
worldwide, especially in Sub-Saharan Africa and to a lesser extent,
Latin America. The infection begins with the bite of
Simulium
spp. insects, which inoculate third-stage nematode larvae
that settle in the skin and subcutaneous tissues of the host,
where they evolve into adult male and female parasites and
are ultimately encapsulated in a fibrous reaction known as
onchocercoma. The female goes on producing thousands of
microfilariae on a daily basis and these larvae migrate through
the skin until they are extracted in the bite of another
Simulium
spp., which thus acts as an intermediary host and vector. While
onchocerciasis is characterized by an important skin involvement,
the severe ocular disease can lead to blindness. Clinical
manifestations are caused by the host immune response against
the nematode and its contents, the endosymbiont
Wolbachia sp.
This response is dependent upon both the innate and adaptive
immune systems, resulting in a mixed Th1/Th2 reaction. So far,
the strategy used to control the disease has been the massive
distribution of ivermectin in high-risk populations; however, this
has proven to be ineffective. Although other approaches have
been tried, including an anti-
Wolbachia treatment, it is imperative
to develop more effective drugs to eradicate this disease.
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