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