A ROLE FOR TUMOR-NECROSIS-FACTOR-ALPHA IN ACUTE LYMPHATIC FILARIASIS

A spectrum of clinical manifestations is a feature of human lymphatic filariasis. The acute disease is characterized by periodic and self li miting episodes of adenolymphangitis, fever and associated constitutio nal symptoms, while the chronic disease includes long lasting manifest ations such as lymphoedema and/or hydrocoele. The microfilariae carrie rs are generally free of clinical symptoms. In the present study circu lating Tumour Necrosis Factor (TNF-alpha) was measured in human bancro ftian filariasis with different clinical manifestations. Significantly elevated levels were observed only in patients with acute disease and not in microfilariae carriers of in patients with chronic manifestati ons. A detailed analysis of the acute cases indicated an absence of co rrelation between TNF-alpha levels and duration of the episodes. Howev er, a significant positive correlation was observed between the severi ty of the disease and the TNF-alpha levels. About 85% of the acute cas es with severe manifestations showed raised levels of TNF-alpha while only 6.5% of mild cases showed such levels. manifestation of fever was also significantly associated with higher levels of TNF-alpha - while 80% of acute cases with fever had significant levels only 24% of acut e cases without fever had high levels of TNF-alpha. Based on these obs ervations we propose a mediatory role for TNF-alpha - in acute filaria sis and the possible use of TNF-alpha inhibitors for clinical manageme nt of the disease.