IVD of Filariodidea

Background

Filarial worms belong to the superfamily Filarioidea and are transmitted by different species of mosquitoes. They are a general term for a class of parasitic nematodes that parasitize humans and other vertebrates. Filariasis is a parasitic disease caused by filarial worms parasitizing in lymphoid tissue, subcutaneous tissue, or serosal cavity. Filariasis mainly manifests as lymphangitis and lymphadenitis in the early stage, while in the late stage, it will produce a series of symptoms, including lymphedema, hydrocele, and chyluria. These diseases negatively impact human and animal health, so the prevention and control of filarial animals are very important.

Filarial life-cycleFig1. Filarial life-cycle. (Ehrens A, et al., 2022)

Main Steps of IVD for Filariodidea

  • Serological tests. The patient's peripheral blood was collected for smear examination. For chyluria or lymphatic effusion, take a sediment smear after centrifugation.
  • Antibody testing. Antibodies were detected using the indirect fluorescent antibody test (IFAT) for adult worm frozen section antigens, the immunoenzyme staining test (IEST) for adult worm frozen sections, and the soluble antigen enzyme-linked immunosorbent assay (ELISA) for filarial worms.
  • Antigen testing. Filarial antigens were detected by the ELISA double antibody method and spot ELISA using monoclonal antibodies against filarial antigens.
  • Filarial complement fixation test.

Classifications of filariasis

Lymphatic Filariasis:

  • Causative Agents: Wuchereria bancrofti, Brugia malayi, and Brugia timori.
  • Transmission: Mosquitoes.
  • Affected Areas: Lymphatic system, including lymph nodes and lymph vessels.
  • Symptoms: Can cause lymphedema (swelling), elephantiasis (thickening of the skin and underlying tissues), and hydrocele (swelling of the scrotum).

Subcutaneous Filariasis:

  • Causative Agents: Loa loa (the African eye worm) and Onchocerca volvulus.
  • Transmission: Loa loa by deer flies (Chrysops species), Onchocerca volvulus by blackflies (Simulium species).
  • Affected Areas: Subcutaneous layer of the skin, eyes.
  • Symptoms: Loa loa infection causes Loiasis, characterized by Calabar swellings and migration of adult worms through the subcutaneous tissues, occasionally passing across the eye. Onchocerca volvulus causes Onchocerciasis, or river blindness, leading to severe itching, skin nodules, and potentially blindness.

Serous Cavity Filariasis:

  • Causative Agents: Mansonella perstans, Mansonella ozzardi, and Mansonella streptocerca.
  • Transmission: Biting midges (Culicoides species) or blackflies.
  • Affected Areas: Body cavities such as the peritoneal cavity, pleural cavity, and pericardium.
  • Symptoms: Often mild or asymptomatic, but can include joint pain, fever, headaches, and in some cases, dermatitis.

Creative BioMart provides high-quality recombinant filariasis protein used for IVD, including ELISA, lateral flow assay, western blot, and other immunoassays.

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  • A wide range of immune tests are available, such as ELISA, lateral flow, WB, and others.
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Application

Filariasis-related proteins are associated with the parasitic infection caused by filarial worms, which are responsible for diseases such as lymphatic filariasis. These proteins, derived from the parasite or the host's immune response, have a variety of applications in biomedical research and public health.

Diagnostic Tools: Proteins from filarial worms can be used to develop diagnostic tests. These tests can detect specific antigens or antibodies related to filarial infections, aiding in the early diagnosis and management of the disease. Examples include immunoassays like ELISA that can identify filarial antibodies in blood samples.

Vaccine Development: Proteins from filarial parasites are potential candidates for developing vaccines. Identifying antigens that elicit strong immune responses can help create vaccines to prevent filariasis. Research is ongoing to find effective protein targets that can provide immunity against the parasites.

Therapeutic Targets: Filariasis-related proteins are being studied to identify new drug targets. By understanding the protein functions and their roles in the parasite's lifecycle, researchers can develop specific inhibitors or drugs that disrupt these processes, thereby treating the infection.

Immune Response Studies: Studying host proteins involved in immune responses to filarial infections helps improve understanding of how the immune system interacts with the parasite. This can lead to improved treatments that modulate the immune response more effectively.

Biomarker Discovery: Identifying specific filariasis-related proteins as biomarkers can help in monitoring disease progression, evaluating treatment efficacy, and conducting epidemiological studies.

Research Tools: Filariasis-related proteins are used as research tools to study the molecular biology and pathogenesis of filarial infections. This can include understanding how the parasites invade, survive, and cause disease in their hosts.

Public Health Surveillance: Proteins can be employed in mass screening programs to monitor the spread of filariasis in endemic regions, helping in the planning and implementation of public health interventions.

Allergen Characterization: Some filarial proteins are known to cause allergic reactions. Characterizing these can lead to a better understanding of parasite-induced allergies and the development of treatments to reduce allergic manifestations.

Case Study

Case 1: Srinivasan P, Ray R, Jandhyala S, Agarwal R. Extralymphatic Filariasis. Indian Dermatol Online J. 2023 Nov 24;15(1):92-94. doi: 10.4103/idoj.idoj_152_23. PMID: 38283023; PMCID: PMC10810389.

Filariasis caused by nematodes affects the structure and function of lymphatic vessels. The authors report a rare case of a 25-year-old man with live extralymphatic filarial infestation presenting as a facial subcutaneous soft-tissue swelling confirmed by ultrasonography (USG), which revealed the filarial dance sign. Filariasis can present in many different ways and pose a significant dilemma for the clinician.

Fig2. USG revealed the filarial dance sign and a live worm in the subcutaneous swelling

Case 2: Koray MH. Ghana's path towards eliminating lymphatic filariasis. Trop Med Health. 2024 May 11;52(1):37. doi: 10.1186/s41182-024-00596-2. PMID: 38734648; PMCID: PMC11088759.

Lymphatic filariasis, also known as elephantiasis, is a debilitating parasitic disease that has been prevalent in various parts of the world, including China and Ghana. This paper explores the historical context of lymphatic filariasis in Ghana and China, as well as the fights towards eliminating the disease in both countries.

Fig3. Population treated and ivermectin distribution from 2000 to 2015 (Source: Biritwum et al.)

Case 3: Waje T, Iliyasu C, Yaki LM, Auta IK. A review of epidemiology of lymphatic filariasis in Nigeria. Pan Afr Med J. 2024 Mar 27;47:142. doi: 10.11604/pamj.2024.47.142.39746. PMID: 38933431; PMCID: PMC11204990.

Lymphatic filariasis is a neglected tropical disease that affects the lymphatic system of humans. The major etiologic agent is a nematode called Wuchereria bancrofti, but Brugia malayi and Brugia timoriare sometimes encountered as causative agents. Mosquitoes are the vectors while humans the definitive hosts respectively. Sustained MDAs, the right testing methods, early treatment of infected cases, and vector control are useful for the elimination of lymphatic filariasis for morbidity management and disability prevention in the country. Regional control strategies, improved quality monitoring of surveys and intervention programs with proper records of morbidity and disability requiring intervention are important approaches for the timely elimination of the disease in Nigeria.

Fig4. Wuchereria bancrofti microfilaria