Elephantiasis

Elephantiasis is caused by parasitic worms such as Brugia Timori,Wuchereria Bancroft and Brugia Malayi. These worms reside in lymphatic system which causes imbalance in body fluids in the lymphatic vessels. These worms target the lower torso of the body specifically the limbs, breasts and genitals.

Brugia Malayi - mostly found in. Asia(South China,India,Indonesia,Thailand,Vietnam.They are transmitted by Mansonia Mosquitoes.

Wuchereria BancroftI - it was named after by physician Otto Wuchereria and parasitologist Joseph Bancrofti. They are transmitted through Anopheles mosquitoes,

Brugia Timori - they are commonly found in Islands of Timor and are transmitted through Anopheles Barbirostris.

Mode of transmission

Mosquitoes transfer larvae through proboscis stem to the wound on the skin of the host. These larvae mature and acccumulate in the lymph node, while the microfilaria ( offsprings) circulates in the peripheral blood. Incubation period can last from 4 weeks to 16 months. The matured parasites accumulate and blocks the lymph flow causing swelling.

The growth of these worms in the vessel blocks the lymphatic system and hence diminishes it's ability to fight infections. Since the growth is gradual it goes un recognized by the body.They also have the ability to detect slight variations in the physiology and metabolism in the host's body and hence alter changes for sustainance. Therefore it has the ability to impair or inhibit the immune system of the host.
First line defense- Body's first line defense against filarial worms is the skin which is waterproof and act as a mechanical barrier with tough keratinized protein. Also the epidermal appendages aids in this function along with the thrombocytes that help to clot and form fibrous scar tissue.

Second line defense - the eosinophils and mast cells (produces cytokines which attracts other cells of immune system to the site of the wound for tissue repair) causes vasodilation and increase permeability of the blood vessels leading to increased blood flow and fluid leakage.Common symptoms are swelling,chill and sweating.

humoral and cell mediated immune responses

HUMORAL IMMUNE RESPONSE - Antigen bond to the B lymphocytes receptors and they divide and activates through clonal selection.Later they differentiate into plasma cells and memory B cells. Plasma cells produces antibody IgE, IgG4,IgG1 that binds to the foreign antigens and tags it for identification by the helper T cells. Memory B cells are for immunological memory for immune response during the second invasion of the the microbes.

CELL MEDIATED IMMUNE RESPONSE - First lymphocyte to be activated is T lymphocyte which is produced in the thymus .They are of 2 common types called cytotoxic T cells ( kills infected cells) and helper T cells or CD4 ( activates macrophage, B lymphocytes and cytotoxic T cells). Dendritic cells (class 2 MHC or the professional antigen presenting cell) invade the microbes through phagocytosis and move to the peripheral lymphoid organs( thymus,spleen,tonsils,lymph nodes). There they act as antigen presenting cell to the helper T cells which releases cytokines for the rapid division of B cells through clonal selection which then differentiate into plasma cells and memory B cells. Helper T cells recognize the foreign antigen tagged by the antibodies and activates cytotoxic T cells by releasing cytokines IL-4,IL -5, IL-9, IL -10, IL-11, IL-12. Once activated T cells migrate to the cite of infection and kills the microbes tagged by the antibodies and hence fight infection along with other phagocytic cells.

Disfigurement of limbs
There is no vaccine for this though antibiotics and antihistamines can treat acute symptoms.

Medication

Diethyl Carbamazine, combination of Albendazole and Ivermectin which causes paralysis of microfilariae and prevent migration.

Other methods - bed rest, Elevation of affected limbs, compression bandages( to bring down the swelling).

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