Table 4 |
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The parasite and host mechanisms possibly involved in loa-associated encephalopathy |
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PARASITE RELATED MECHANISMS |
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Massive movement and death of parasite clumps in vessels → embolic blockage → local vascular inflammation and subsequent tissue damage in sensitive tissues (similarities to malaria) |
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Reactions against dying adult worms or wandering larvae? |
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Due to two or more parasite species being present |
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PATIENT RELATED MECHANISMS |
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PATHOLOGICAL |
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Effects of alcohol (co-administration and/or chronic changes) |
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Effects of food (co-administration) |
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Gut disease (increasing uptake) |
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Altered processing (liver damage) |
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Other co-existent infections or disease processes |
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CNS Toxicity (overdose) |
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Allergic drug sensitivity (rare) |
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GENETIC |
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Blood Brain Barrier Alterations |
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Mdr1 mutation – homozygous |
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Human equivalent to dogs, mice, knockout mice and cattle |
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Polymorphism to inflammation |
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Pro- versus anti-inflammatory cytokine expression |
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Genetic predisposition to microfilariaemia |
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Mackenzie et al. Filaria Journal 2003 2(Suppl 1):S5 doi:10.1186/1475-2883-2-S1-S5 |
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