Lymphatic filariasis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Overview
Infective larvae are transmitted by infected biting mosquitoes during a blood meal. The larvae migrate to lymphatic vessels and lymph nodes, where they develop into microfilariae-producing adults. The adults dwell in lymphatic vessels and lymph nodes where they can live for several years. The female worms produce microfilariae which circulate in the blood. The microfilariae infect biting mosquitoes. Inside the mosquito, the microfilariae develop in 1 to 2 weeks into infective filariform (third-stage) larvae. During a subsequent blood meal by the mosquito, the larvae infect the vertebrate host. They migrate to the lymphatic vessels and lymph nodes of the human host, where they develop into adults.
Pathophysiology
Life Cycle of Wuchereria Bancrofti
Different species of the following genera of mosquitoes are vectors of W. bancrofti filariasis depending on geographical distribution. Among them are: Culex (C. annulirostris, C. bitaeniorhynchus, C. quinquefasciatus, and C. pipiens); Anopheles (A. arabinensis, A. bancroftii, A. farauti, A. funestus, A. gambiae, A. koliensis, A. melas, A. merus, A. punctulatus and A. wellcomei); Aedes (A. aegypti, A. aquasalis, A. bellator, A. cooki, A. darlingi, A. kochi, A. polynesiensis, A. pseudoscutellaris, A. rotumae, A. scapularis, and A. vigilax); Mansonia (M. pseudotitillans, M. uniformis); Coquillettidia (C. juxtamansonia). During a blood meal, an infected mosquito introduces third-stage filarial larvae onto the skin of the human host, where they penetrate into the bite wound (1). They develop in adults that commonly reside in the lymphatics (2) . The female worms measure 80 to 100 mm in length and 0.24 to 0.30 mm in diameter, while the males measure about 40 mm by .1 mm. Adults produce microfilariae measuring 244 to 296 μm by 7.5 to 10 μm, which are sheathed and have nocturnal periodicity, except the South Pacific microfilariae which have the absence of marked periodicity. The microfilariae migrate into lymph and blood channels moving actively through lymph and blood (3) . A mosquito ingests the microfilariae during a blood meal (4). After ingestion, the microfilariae lose their sheaths and some of them work their way through the wall of the proventriculus and cardiac portion of the mosquito's midgut and reach the thoracic muscles (5). There the microfilariae develop into first-stage larvae (6) and subsequently into third-stage infective larvae (7). The third-stage infective larvae migrate through the hemocoel to the mosquito's prosbocis (8) and can infect another human when the mosquito takes a blood meal (1).
Life Cycle of Brugia Malayi
The typical vector for Brugia malayi filariasis are mosquito species from the genera Mansonia and Aedes. During a blood meal, an infected mosquito introduces third-stage filarial larvae onto the skin of the human host, where they penetrate into the bite wound (1). They develop into adults that commonly reside in the lymphatics (2). The adult worms resemble those of Wuchereria bancrofti but are smaller. Female worms measure 43 to 55 mm in length by 130 to 170 μm in width, and males measure 13 to 23 mm in length by 70 to 80 μm in width. Adults produce microfilariae, measuring 177 to 230 μm in length and 5 to 7 μm in width, which are sheathed and have nocturnal periodicity. The microfilariae migrate into lymph and enter the blood stream reaching the peripheral blood (3). A mosquito ingests the microfilariae during a blood meal (4). After ingestion, the microfilariae lose their sheaths and work their way through the wall of the proventriculus and cardiac portion of the midgut to reach the thoracic muscles (5). There the microfilariae develop into first-stage larvae (6) and subsequently into third-stage larvae (7). The third-stage larvae migrate through the hemocoel to the mosquito's prosbocis (8) and can infect another human when the mosquito takes a blood meal (1).
Vectors
A wide range of mosquitoes can transmit the parasite, depending on the geographic area. In Africa, the most common vector is Anopheles and in the America, it is Culex quinquefasciatus. Aedes and Mansonia can transmit the infection in the Pacific and in Asia.
Shown below is an image of an Anopheles gambiae mosquito taking a blood meal.
Shown below is an image of many species in the genera Anopheles that can transmit the infective larvae that cause lymphatic filariasis.
Shown below is an image of Culex quinquefasciatus, a vector of lymphatic filariasis.
Shown below is an image of Culex that transmits the infective larva of Waucheria bancrofti and brugia malayi.
Shown below is an image of an Aedes aegypti female mosquito taking a blood meal.
Shown below is an image of Aedes that transmits the infective larvae of Waucheria bancrofti and brugia malayi .
Microscopic Pathology
Shown below is an image of microfilaria of Wuchereria bancrofti.
Shown below is an image of microfilaria of Brugia malayi.
